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结直肠癌诊断后新发抑郁:一项基于人群的纵向研究。

New-onset depression after colorectal cancer diagnosis: a population-based longitudinal study.

机构信息

Department of Medicine, Hackensack Meridian Health Palisades Medical Center, 7600 River Road, North Bergen, NJ, 07047, USA.

Department of Medicine, Case Western Reserve University, Cleveland, OH, USA.

出版信息

Int J Colorectal Dis. 2021 Dec;36(12):2599-2602. doi: 10.1007/s00384-021-03994-8. Epub 2021 Jul 17.

Abstract

INTRODUCTION

To date, no large studies examining the temporal relationship between colorectal cancer (CRC) and the subsequent development of depressive disorders exist. We aimed to assess the incidence of depression post-colorectal cancer (CRC) diagnosis.

METHODS

To conduct this longitudinal study, we searched the large US population-based database, Explorys (IBM), from January 1, 1999, to January 1, 2021. We investigated new-onset depression and its associated mortality as well as the role of the mental health provider post-CRC diagnosis. Confidence intervals were calculated for all outcomes and multivariate regression analysis was performed.

RESULTS

Incident depression post-CRC diagnosis was 20.8 vs 8.9 per 100 person-years [OR 3.46, p < 0.0001] in the general population and conferred a 123% increased risk of all-cause mortality [P < 0.0001]. Male patients (OR: 1.89) were more likely to become depressed post-CRC diagnosis as compared to females. Moreover, the absolute number of male patients with post-CRC depression was significantly higher than that of females (68% vs 32%; P < 0.0001). In addition, depression after CRC was more common among Whites (OR: 1.68) and patients aged > 65 years (OR: 5.17). Referral to a mental health provider resulted in significantly lower all-cause mortality (3.6% vs 26.9%; p < 0.0001).

DISCUSSION

Our findings advocate for initiating depression screening for high-risk patients post-CRC diagnosis and prompt mental health provider referral.

摘要

简介

迄今为止,尚无研究探讨结直肠癌(CRC)与随后发生抑郁障碍之间的时间关系。本研究旨在评估结直肠癌(CRC)诊断后抑郁的发生率。

方法

为了进行这项纵向研究,我们在 1999 年 1 月 1 日至 2021 年 1 月 1 日期间,在美国大型人群数据库 Explorys(IBM)中进行了搜索。我们调查了 CRC 诊断后新发抑郁及其相关死亡率,以及精神卫生服务提供者的作用。所有结果的置信区间均进行了计算,并进行了多变量回归分析。

结果

CRC 诊断后新发抑郁的发生率在一般人群中为 20.8/100 人年,而在 CRC 患者中为 8.9/100 人年[比值比(OR):3.46,p<0.0001]。CRC 后新发抑郁患者的全因死亡率增加了 123%(P<0.0001)。与女性相比,男性患者(OR:1.89)在 CRC 后更易发生抑郁。此外,CRC 后男性患者抑郁的绝对人数明显高于女性(68%比 32%;P<0.0001)。此外,CRC 后抑郁在白人(OR:1.68)和年龄>65 岁的患者中更为常见(OR:5.17)。向精神卫生服务提供者转诊可显著降低全因死亡率(3.6%比 26.9%;p<0.0001)。

讨论

我们的研究结果主张对 CRC 后高危患者进行抑郁筛查,并及时向精神卫生服务提供者转诊。

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