Bach Anne, Knauer Klara, Graf Johanna, Schäffeler Norbert, Stengel Andreas
Section Psychooncology, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen 72076, Germany.
World J Psychiatry. 2022 Apr 19;12(4):623-635. doi: 10.5498/wjp.v12.i4.623.
Psychiatric disorders are common but underdiagnosed in cancer survivors. Research suggests that tumor type has an effect on the prevalence of clinically relevant depression, anxiety, comorbid anxiety-depression and posttraumatic stress disorder (PTSD).
To identify studies that examined the prevalence of clinically relevant levels of depression, anxiety, comorbid anxiety-depression and PTSD for patients with one or more tumor sites and compare those prevalences between cancer subtypes.
Four databases (PubMed, PsycInfo, PubPsych and the Cochrane Database) were searched and resulted in a total of 2387 articles to be screened. To be included, a study must have investigated cancer-free and posttreatment survivors using tools to assess clinically relevant levels of the listed psychiatric comorbidities. All articles were screened by two authors with a third author reviewing debated articles.
Twenty-six studies on ten different tumor types fulfilled all inclusion criteria and were included in the review. The studies showed heterogeneity regarding the study characteristics, number of participants, time since diagnosis, and assessment tools. Generally, all four comorbidities show higher prevalences in cancer survivors than the general population. Brain tumor survivors were reported to have a relatively high prevalence of both depression and anxiety. Studies with melanoma survivors reported high prevalences of all four psychiatric comorbidities. Regarding comorbidities, a wide range in prevalence existed across the tumor types. Within one cancer site, the prevalence also varied considerably among the studies.
Psychiatric comorbidities are more frequent in cancer survivors than in the general population, as reflected by the prevalence of depression, anxiety, comorbid anxiety-depression and PTSD across all tumor subtypes. Developing generalized screening tools that examine psychological distress in cancer survivors up to at least ten years after diagnosis could help to understand and address the psychological burden of cancer survivors.
精神疾病在癌症幸存者中很常见，但诊断不足。研究表明，肿瘤类型对临床相关抑郁症、焦虑症、共病焦虑 - 抑郁症和创伤后应激障碍（PTSD）的患病率有影响。
确定研究检查了一个或多个肿瘤部位患者临床相关水平的抑郁症、焦虑症、共病焦虑 - 抑郁症和PTSD的患病率，并比较癌症亚型之间的这些患病率。
检索了四个数据库（PubMed、PsycInfo、PubPsych和Cochrane数据库），共筛选出2387篇文章。要纳入研究，必须使用工具调查无癌和治疗后的幸存者，以评估所列精神共病的临床相关水平。所有文章由两位作者筛选，第三位作者审查有争议的文章。
关于十种不同肿瘤类型的26项研究符合所有纳入标准并被纳入综述。这些研究在研究特征、参与者数量、诊断后的时间和评估工具方面存在异质性。一般来说，所有四种共病在癌症幸存者中的患病率都高于普通人群。据报道，脑肿瘤幸存者中抑郁症和焦虑症的患病率相对较高。黑色素瘤幸存者的研究报告了所有四种精神共病的高患病率。关于共病，不同肿瘤类型的患病率范围很广。在一个癌症部位内，各研究之间的患病率也有很大差异。
如所有肿瘤亚型中抑郁症、焦虑症、共病焦虑 - 抑郁症和PTSD的患病率所反映的，精神共病在癌症幸存者中比在普通人群中更常见。开发能够在诊断后至少十年内检查癌症幸存者心理困扰的通用筛查工具，有助于理解和解决癌症幸存者的心理负担。
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