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新诊断癌症患者中的精神障碍和精神卫生服务利用情况:基于德国健康保险索赔数据的分析。

Mental disorders and utilization of mental health services in newly diagnosed cancer patients: An analysis of German health insurance claims data.

机构信息

Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Cologne, Germany.

PMV forschungsgruppe, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.

出版信息

Psychooncology. 2021 Mar;30(3):312-320. doi: 10.1002/pon.5579. Epub 2020 Oct 30.

Abstract

OBJECTIVE

People with cancer are often confronted not only with the burdens of medical treatment but also with psychological strain, which can lead to mental disorders (MD). To date, the prevalence of MD in newly diagnosed cancer patients and their utilization of mental health services (MHS) are mainly estimated through data of primary studies than considering healthcare-related claims data.

METHODS

Statutory health insurance claims data of the AOK/KV Hesse from 2011 to 2014 was analyzed. The number of incident cancer patients with MD and the utilization of MHS within the period of the quarter of incident cancer diagnosis and three subsequent quarters were determined. For incident cancer patients with an incident MD, the predictive values of sex, age group, and tumor entity on the documentation of MD diagnosis and utilization were investigated.

RESULTS

The 12-month prevalence of MD in incident cancer patients was 31.1% for depression, 11.2% for anxiety disorders, and 9.2% for post-traumatic stress/adjustment disorder (PTSD/AD). Of these, 65.9% received outpatient psychotherapy and 43.0% at least one psychopharmacological drug prescription. Men had a significantly lower chance of receiving an MD diagnosis following cancer.

CONCLUSIONS

The prevalence of MD observed was higher for depression and lower for PTSD/AD compared to meta-analyses of clinical trials. Male cancer patients had a lower chance of receiving an MD diagnosis than females, which coincides with existing results.

摘要

目的

癌症患者不仅经常面临医疗负担,还面临心理压力,这可能导致精神障碍(MD)。迄今为止,新发癌症患者的 MD 患病率及其对精神卫生服务(MHS)的利用主要是通过对初级研究数据的估计,而不是考虑与医疗保健相关的索赔数据。

方法

分析了 2011 年至 2014 年 AOK/KV 黑森州的法定健康保险索赔数据。确定了在癌症诊断后的季度和随后的三个季度内患有 MD 的新发癌症患者人数和 MHS 的利用情况。对于患有新发 MD 的新发癌症患者,调查了性别、年龄组和肿瘤实体对 MD 诊断和利用记录的预测值。

结果

新发癌症患者 MD 的 12 个月患病率为抑郁症 31.1%、焦虑症 11.2%和创伤后应激/适应障碍(PTSD/AD)9.2%。其中,65.9%接受门诊心理治疗,43.0%至少接受一种精神药物处方。男性患 MD 的可能性明显低于女性。

结论

与临床试验的荟萃分析相比,观察到的 MD 患病率在抑郁症中较高,在 PTSD/AD 中较低。与现有结果一致,男性癌症患者比女性患者更有可能被诊断为 MD。

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