Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, Alberta, Canada.
JCO Oncol Pract. 2020 Jul;16(7):e601-e609. doi: 10.1200/JOP.19.00497. Epub 2020 Feb 18.
To evaluate the association between cancer diagnosis and depression and suicidal ideation in a population-based cohort in the United States.
This was a cross-sectional study based on the National Health and Nutrition Examination Survey (NHANES) conducted for the years 2005 to 2016. Depression was assessed using a validated tool (Patient Health Questionnaire-9, and suicidal ideation was assessed by item number 9 of this tool. Propensity score matching was conducted to match survey respondents with cancer versus those without cancer. Multivariable logistic regression analysis was then conducted to evaluate factors associated with higher probability of depression and suicide among the whole postpropensity cohort.
A total of 32,178 survey respondents were eligible and included in the study. These included 3,043 respondents with cancer and 29,675 respondents without cancer. Within the postpropensity cohort, a cancer diagnosis was not associated with a higher probability of depressive disorders (odds ratio, 0.937; 95% CI, 0.819 to 1.073), whereas it was associated with a higher probability of suicidal ideation (for respondents without cancer those with cancer: odds ratio, 0.695; 95% CI, 0.517 to 0.935).
Cancer diagnosis is associated with a higher probability of suicidal ideation. Screening for suicidal ideation should be part of the assessment of patients with cancer.
在美国的一个基于人群的队列中评估癌症诊断与抑郁和自杀意念之间的关联。
这是一项基于 2005 年至 2016 年进行的国家健康和营养检查调查（NHANES）的横断面研究。使用经过验证的工具（患者健康问卷-9）评估抑郁，使用该工具的第 9 项评估自杀意念。采用倾向评分匹配将患有癌症的调查对象与没有癌症的调查对象进行匹配。然后进行多变量逻辑回归分析，以评估整个倾向后队列中与抑郁和自杀可能性较高相关的因素。
共有 32178 名符合条件的调查对象纳入研究。其中包括 3043 名癌症患者和 29675 名非癌症患者。在倾向后队列中，癌症诊断与抑郁障碍的可能性增加无关（比值比，0.937；95%CI，0.819 至 1.073），但与自杀意念的可能性增加有关（对于无癌症的患者，与癌症患者相比：比值比，0.695；95%CI，0.517 至 0.935）。
癌症诊断与自杀意念的可能性增加有关。应该将自杀意念筛查作为癌症患者评估的一部分。
