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重度抑郁症与血液系统癌症和实体癌过早死亡风险之间的关联:一项纵向队列研究。

The association between Major Depressive Disorder and premature death risk in hematologic and solid cancer: a longitudinal cohort study.

作者信息

Sancassiani Federica, Massa Elena, Pibia Carla, Perda Giulia, Boe Laura, Fantozzi Elena, Cossu Giulia, Caocci Giovanni, Mulas Olga, Morelli Emanuela, Lindert Jutta, Lai Eleonora, Nardi Antonio Egidio, Scartozzi Mario, La Nasa Giorgio, Carta Mauro Giovanni

机构信息

Department of Medical Sciences and Public Health, University of Cagliari.

Department of Medical Sciences and Public Health, University of Cagliari, Italy .

出版信息

J Public Health Res. 2021 May 5;10(3):2247. doi: 10.4081/jphr.2021.2247.

Abstract

BACKGROUND

the aim was to verify the association between Major Depressive Disorders (MDD) and the risk of premature death in people with oncological diseases, and to collect evidence about the causality of a possible association from a longitudinal perspective.

DESIGN AND METHODS

it is a cohort study lasting 9 months, involving people with solid or hematologic cancers. The assessment was conducted by an ad hoc form to collect socio-demographic and clinical-oncological data, the PHQ-9 to screen MDD (cut-off ≥10) and the SF-12 to evaluate HRQoL. Relative Risk (RR) of early death between MDD exposed and not-exposed and Kaplan-Meier survival were carried out.

RESULTS

people exposed to MDD during the follow-up were 107/263 (40.7%). Among them, 36 deceased during the observation period. Overtime, having MDD and death' occurrence showed a strong association (RR=2.15; 95% CI (1.10-4.20); χ²=5.224, p=0.0022), confirmed by Kaplan-Meier survival analysis (χ²=4.357, p=0.037). Among people who died, there was not any association between MDD, age, gender, HRQoL, cancer stage and site.

CONCLUSIONS

the study confirms the association between MDD and early death in people with cancer. The absence of any association between the onset of MDD and advanced stage of cancer may suggest that it could be due to the consequences of MDD in worsening the clinical conditions related to cancer. The findings point out the relevance of MDD' early detention among people with cancer.

摘要

背景

目的是验证重度抑郁症(MDD)与肿瘤疾病患者过早死亡风险之间的关联,并从纵向角度收集有关可能关联因果关系的证据。

设计与方法

这是一项为期9个月的队列研究,涉及实体癌或血液系统癌症患者。通过专门设计的表格收集社会人口统计学和临床肿瘤学数据,使用PHQ-9筛查MDD(临界值≥10),使用SF-12评估健康相关生活质量(HRQoL)。对暴露于MDD和未暴露于MDD的患者进行早期死亡相对风险(RR)分析以及Kaplan-Meier生存分析。

结果

随访期间暴露于MDD的患者为107/263(40.7%)。其中,36人在观察期内死亡。随着时间推移,患有MDD与死亡发生之间显示出强烈关联(RR=2.15;95%置信区间(1.10 - 4.20);χ²=5.224,p=0.0022),Kaplan-Meier生存分析证实了这一点(χ²=4.357,p=0.037)。在死亡患者中,MDD、年龄、性别、HRQoL、癌症分期和部位之间没有任何关联。

结论

该研究证实了MDD与癌症患者早期死亡之间的关联。MDD的发生与癌症晚期之间不存在任何关联,这可能表明这是由于MDD导致与癌症相关临床状况恶化的结果。研究结果指出了在癌症患者中早期发现MDD的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58f5/8506198/74da58c59163/jphr-10-3-2247-g001.jpg

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