Department of Health Policy and Management, Gillings School of Global Public Health, the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
RTI International, Research Triangle Park, North Carolina.
Cancer Med. 2019 Jul;8(8):3648-3658. doi: 10.1002/cam4.2239. Epub 2019 May 20.
Appropriate depression care is a cancer-care priority. However, many cancer survivors live with undiagnosed and untreated depression. Prostate cancer survivors may be particularly vulnerable, but little is known about their access to depression care. The goal of this study was to describe patterns and predictors of clinical diagnosis and treatment of depression in prostate cancer survivors.
Generalized estimating equations were used to evaluate indicators of self-reported clinical diagnosis and treatment depression as a function of individual-level characteristics within a longitudinal dataset. The data were from a population-based cohort of North Carolinian prostate cancer survivors who were enrolled from 2004 to 2007 on the North Carolina-Louisiana Prostate Cancer Project (N = 1,031), and prospectively followed annually from 2008 to 2011 on the Health Care Access and Prostate Cancer Treatment in North Carolina (N = 805).
The average rate of self-reported clinical diagnosis of depression was 44% (95% CI: 39%-49%), which declined from 60% to 40% between prostate cancer diagnosis and 5-7 years later. Factors associated with lower odds of self-reported clinical diagnosis of depression include African-American race, employment, age at enrollment, low education, infrequent primary care visits, and living with a prostate cancer diagnosis for more than 2 years. The average rate of self-reported depression treatment was 62% (95% CI: 55%-69%). Factors associated with lower odds of self-reported depression treatment included employment and living with a prostate cancer diagnosis for 2 or more years.
Prostate cancer survivors experience barriers when in need of depression care.
适当的抑郁护理是癌症护理的重点。然而，许多癌症幸存者患有未被诊断和未得到治疗的抑郁症。前列腺癌幸存者可能特别容易受到影响，但人们对他们获得抑郁护理的机会知之甚少。本研究的目的是描述前列腺癌幸存者临床诊断和治疗抑郁的模式和预测因素。
使用广义估计方程来评估个体水平特征与自我报告的临床诊断和治疗抑郁之间的关系，这是基于一个纵向数据集。数据来自北卡罗来纳州前列腺癌幸存者的基于人群的队列，他们于 2004 年至 2007 年在北卡罗来纳州-路易斯安那州前列腺癌项目（N=1031）中注册，并在 2008 年至 2011 年期间在北卡罗来纳州的医疗保健获取和前列腺癌治疗中进行了前瞻性随访（N=805）。
自我报告的临床诊断为抑郁症的平均比率为 44%（95%置信区间：39%-49%），从前列腺癌诊断时的 60%下降到 5-7 年后的 40%。与自我报告的临床诊断为抑郁症的几率较低相关的因素包括非裔美国人种族、就业、注册时的年龄、低教育程度、定期看初级保健医生的次数少以及患有前列腺癌诊断超过 2 年。自我报告的抑郁治疗的平均比率为 62%（95%置信区间：55%-69%）。与自我报告的抑郁治疗几率较低相关的因素包括就业和患有前列腺癌诊断超过 2 年。
前列腺癌幸存者在需要抑郁护理时会遇到障碍。
