Department of Surgery, Rigshospitalet, Copenhagen University, Copenhagen, Denmark.
Unit of Survivorship & Inequality in Cancer, Danish Cancer Society Research Centre, Danish Cancer Society, Copenhagen, Denmark.
Support Care Cancer. 2021 Nov;29(11):6689-6699. doi: 10.1007/s00520-021-06251-4. Epub 2021 May 8.
Pancreatic cancer (PC) has high morbidity and mortality and is stressful for patients and their partners. We investigated the psychological symptom burden in partners of PC patients.
We followed 5774 partners of PC patients diagnosed from 2000 to 2016 up for first redeemed prescriptions of antidepressants or hospital admission, anxiolytics, and hypnotics as proxies for clinical depression, anxiety, and insomnia and compared them with 59,099 partners of cancer-free spouses. Data were analysed using Cox regression and multistate Markov models.
The cumulative incidence proportion of first depression was higher in partners of PC patients compared to comparisons. The highest adjusted HR of first depression was seen the first year after diagnosis (HR 3.2 (95% CI: 2.9; 3.7)). Educational level, chronic morbidity, and bereavement status were associated with an increased risk of first depression. There was a significantly higher first acute use (1 prescription only) of both anxiolytics and hypnotics and chronic use (3+ prescriptions) of hypnotics in partners of PC patients than in comparisons.
Being a partner to a PC patient carries a substantial psychological symptom burden and increases the risk for first depression and anxiolytic use and long-term use of hypnotics. Attention should be given to the psychological symptom burden of partners of PC patients, as this may pose a barrier for the optimal informal care and support of the PC patient, as well as a risk for non-optimal management of symptoms in the partner.
胰腺癌（PC）发病率和死亡率高，给患者及其伴侣带来压力。我们研究了 PC 患者伴侣的心理症状负担。
我们随访了 5774 名 2000 年至 2016 年间被诊断为 PC 的患者的伴侣，随访他们首次开抗抑郁药或抗焦虑药、镇静催眠药的处方，这些药物是临床抑郁、焦虑和失眠的替代指标，并将他们与 59099 名无癌症配偶的伴侣进行比较。使用 Cox 回归和多状态马尔可夫模型进行数据分析。
与对照组相比，PC 患者伴侣首次抑郁的累积发生率比例更高。首次抑郁的最高调整 HR 见于诊断后第一年（HR 3.2（95%CI：2.9；3.7））。教育程度、慢性发病和丧偶状况与首次抑郁的风险增加相关。PC 患者伴侣首次使用（仅 1 次处方）抗焦虑药和镇静催眠药以及长期使用（3 次以上处方）镇静催眠药的急性使用率明显更高。
作为 PC 患者的伴侣，会带来相当大的心理症状负担，增加首次抑郁和使用抗焦虑药以及长期使用镇静催眠药的风险。应关注 PC 患者伴侣的心理症状负担，因为这可能会成为最佳非正规护理和支持 PC 患者的障碍，也可能成为伴侣症状管理不理想的风险。
