一项关于长期童年、青少年和青年期癌症幸存者中重度抑郁发作的对照研究（NOR-CAYACS研究）。
A Controlled Study of Major Depressive Episodes in Long-Term Childhood, Adolescence, and Young Adult Cancer Survivors (The NOR-CAYACS Study).
作者信息
Dahl Alv A, Kiserud Cecilie Essholt, Fosså Sophie D, Loge Jon Håvard, Reinertsen Kristin Valborg, Ruud Ellen, Lie Hanne C
机构信息
National Advisory Unit on Late Effects after Cancer Treatment, Oslo University Hospital, 0424 Oslo, Norway.
Faculty of Medicine, University of Oslo, 0316 Oslo, Norway.
出版信息
Cancers (Basel). 2021 Nov 18;13(22):5800. doi: 10.3390/cancers13225800.
BACKGROUND
A major depressive episode (MDE) is typically self-rated by screening forms identifying probable MDE (pMDE). This population-based cross-sectional questionnaire study examined the prevalence rates of pMDE identified by the PHQ-9 screener in long-term survivors of childhood and adolescence (CACSs) and young adult cancer (YACSs) and a normative sample (NORMs).
METHODS
Data from 488 CACSs, 1202 YACSs, and 1453 NORMs were analyzed, and pMDE was defined both by cut-off ≥10 on the total PHQ-9 score and by an algorithm.
RESULTS
The prevalence rates of pMDE among CACSs were 21.5%, 16.6% in YACSs, and 9.2% among NORMs using the cut-off definition. With the algorithm, the prevalence rates of pMDE were 8.0% among CACSs, 8.1% among YACSs, and 3.9% among NORMs. Independent of definition, CACSs and YACSs had significantly increased prevalence rates of pMDE compared to NORMs. Psychosocial factors and self-rated health were significantly associated with both definitions of pMDE in multivariable analyses, while survivor groups, cancer types, and adverse events were not.
CONCLUSION
Since pMDE has negative health consequences and is amenable to treatment, healthcare providers should be attentive and screen for pMDE in young cancer survivors. For PHQ-9, the preferred type of definition of pMDE should be determined.
背景
重度抑郁发作（MDE）通常通过筛查表进行自评，以识别可能的MDE（pMDE）。这项基于人群的横断面问卷调查研究，调查了儿童和青少年长期癌症幸存者（CACSs）、青年成人癌症患者（YACSs）以及一个正常样本（NORMs）中通过PHQ-9筛查工具识别出的pMDE患病率。
方法
分析了来自488名CACSs、1202名YACSs和1453名NORMs的数据，pMDE的定义既采用PHQ-9总分≥10的临界值，也采用一种算法。
结果
采用临界值定义时，CACSs中pMDE的患病率为21.5%，YACSs中为16.6%，NORMs中为9.2%。采用算法时，CACSs中pMDE的患病率为8.0%，YACSs中为8.1%，NORMs中为3.9%。无论采用何种定义，与NORMs相比，CACSs和YACSs中pMDE的患病率均显著升高。在多变量分析中，心理社会因素和自评健康状况与pMDE的两种定义均显著相关，而幸存者群体、癌症类型和不良事件则不然。
结论
由于pMDE会对健康产生负面影响且可接受治疗，医疗服务提供者应予以关注，并对年轻癌症幸存者进行pMDE筛查。对于PHQ-9，应确定pMDE的首选定义类型。
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