Department of Population Science and Policy, Southern Illinois University School of Medicine, 201 E. Madison Street, P. O. Box 19664, Springfield, IL, 62794-9664, USA.
Saint Louis University Cancer Center, 3655 Vista Ave, Third Floor, West Pavilion, St. Louis, MO, 63110, USA.
Soc Psychiatry Psychiatr Epidemiol. 2020 Jan;55(1):15-23. doi: 10.1007/s00127-019-01763-1. Epub 2019 Aug 23.
This study aimed to examine the factors associated with diagnosed depression among patients with a metastatic cancer.
We conducted a cross-sectional analysis of 39,223 hospital records from 2008 to 2013 National Inpatient Sample for patients with metastatic cancer. Diagnosed depression was defined using ICD-9-CM for major depression. Weighted, multivariable hierarchical regression model was used to examine the association between sociodemographic and clinical factors and depression among patients with a metastatic cancer.
The prevalence of clinically diagnosed depression in patients with a metastatic cancer in our study sample was 7.3% (5.9% for males and 8.6% for females). The prevalence rate of diagnosed depression increased from 5.3 to 9.4% between 2008 and 2013. In multivariable analysis, patients were more likely to be diagnosed with depression if they were females (aOR = 1.44; 95% CI 1.25-1.66) compared to males; and had higher number of comorbidities (aOR = 1.11 per 1-unit increase in Elixhauser comorbidity score, 95% CI 1.07-1.15). In contrast, patients were less likely to be diagnosed with depression if they were blacks (aOR = 0.59; 95% CI 0.47-0.74) or other race (aOR = 0.58; 95% CI 0.47-0.72) compared with white patients.
Women and individuals with more comorbidities were diagnosed with depression more frequently, whereas black patients were diagnosed less. Our findings could help providers to identify hospitalized patients with the higher risk of depression and screened patients with signs and symptoms of clinical depression.
本研究旨在探讨转移性癌症患者中诊断为抑郁症的相关因素。
我们对 2008 年至 2013 年国家住院患者样本中 39223 例转移性癌症患者的病历进行了横断面分析。使用 ICD-9-CM 对重度抑郁症进行诊断性抑郁症的定义。使用加权、多变量层次回归模型来检查社会人口统计学和临床因素与转移性癌症患者抑郁症之间的关联。
在我们的研究样本中,转移性癌症患者中临床诊断为抑郁症的患病率为 7.3%(男性为 5.9%,女性为 8.6%)。2008 年至 2013 年期间,诊断为抑郁症的患病率从 5.3%上升到 9.4%。在多变量分析中,与男性相比,女性(aOR=1.44;95%CI 1.25-1.66)患者更有可能被诊断为抑郁症;患有更多共病(Elixhauser 共病评分每增加 1 分,aOR=1.11;95%CI 1.07-1.15)。相比之下,与白人患者相比,黑人(aOR=0.59;95%CI 0.47-0.74)或其他种族(aOR=0.58;95%CI 0.47-0.72)患者被诊断为抑郁症的可能性较低。
女性和共病较多的患者更频繁地被诊断为抑郁症,而黑人患者则较少被诊断为抑郁症。我们的研究结果可以帮助提供者识别住院患者中具有更高抑郁风险的患者,并对有临床抑郁症状的患者进行筛查。