Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
BMJ Open. 2020 Jun 29;10(6):e037918. doi: 10.1136/bmjopen-2020-037918.
Depression is a common comorbidity in cancer patients. This study aimed to compare the prevalence and associated factors of depressive disorder between patients with head and neck cancer (HNC) and those with lung cancer (LC).
This study used a cross-sectional design with consecutive sampling.
A medical centre (Kaohsiung Chang Gung Memorial Hospital, Taiwan).
Patients for the study were recruited from the HNC and LC outpatient clinic and inpatient ward from March 2016 to February 2018. Patients with HNC and LC were enrolled and assessed using the Mini International Neuropsychiatric Interview (MINI).
The primary outcome was psychiatric diagnoses assessed using the MINI. The secondary outcomes were psychological well-being assessed using the Beck Anxiety Inventory, Taiwanese Depression Questionnaire, Brief Fatigue Inventory, Numeric Pain Rating Scale and the List of Threatening Experiences Questionnaire.
In total, 113 HNC patients and 104 LC patients were recruited for the study. The most common psychiatric comorbidity of HNC patients was alcohol use disorder (49.6%), followed by adjustment disorder (20.4%) and depressive disorder (11.5%). The most common psychiatric comorbidity of LC patients was depressive disorder (25.0%), followed by adjustment disorder (17.3%), alcohol use disorder (3.8%) and insomnia disorder (3.8%). Among HNC patients, a self-harm history was positively associated with depression (OR=11.91; 95% CI, 1.47 to 96.83), and a higher educational level was negatively associated with depression (OR=0.77; 95% CI, 0.66 to 0.91). Among LC patients, severity of stressor (OR=2.78; 95% CI, 1.50 to 5.15) and severity of anxiety (OR=1.18; 95% CI, 1.04 to 1.34) were two significant factors associated with depression.
We reported the prevalence and associated factors of depression between patients with HNC and those with LC. Clinicians should be aware of this comorbidity and the associated risk factors, and conduct intervention programmes to prevent these cancer patients from developing depression.
抑郁症是癌症患者的常见合并症。本研究旨在比较头颈部癌症（HNC）和肺癌（LC）患者中抑郁障碍的患病率及相关因素。
本研究采用了横断面设计和连续抽样。
台湾高雄长庚纪念医院。
本研究于 2016 年 3 月至 2018 年 2 月从 HNC 和 LC 门诊和住院病房招募患者。使用 Mini 国际神经精神病学访谈（MINI）对 HNC 和 LC 患者进行评估并招募。
主要结果是使用 MINI 评估的精神科诊断。次要结果是使用贝克焦虑量表、台湾抑郁问卷、简短疲劳量表、数字疼痛评分量表和威胁体验清单评估的心理幸福感。
共招募了 113 名 HNC 患者和 104 名 LC 患者进行研究。HNC 患者最常见的精神科合并症是酒精使用障碍（49.6%），其次是适应性障碍（20.4%）和抑郁障碍（11.5%）。LC 患者最常见的精神科合并症是抑郁障碍（25.0%），其次是适应性障碍（17.3%）、酒精使用障碍（3.8%）和失眠障碍（3.8%）。在 HNC 患者中，有自残史与抑郁呈正相关（OR=11.91；95%CI，1.47 至 96.83），而较高的教育水平与抑郁呈负相关（OR=0.77；95%CI，0.66 至 0.91）。在 LC 患者中，应激源严重程度（OR=2.78；95%CI，1.50 至 5.15）和焦虑严重程度（OR=1.18；95%CI，1.04 至 1.34）是与抑郁相关的两个显著因素。
我们报告了 HNC 和 LC 患者中抑郁障碍的患病率及相关因素。临床医生应意识到这种合并症及其相关的危险因素，并开展干预计划，以防止这些癌症患者出现抑郁。
