Department of Biostatistics, School of Public Health, Harbin Medical University, China.
Department of Forensic Medicine, Guizhou Medical University, China.
J Affect Disord. 2023 Nov 1;340:743-750. doi: 10.1016/j.jad.2023.08.091. Epub 2023 Aug 19.
Understanding trend characteristics of depression among cancer survivors is essential for healthcare policies and planning. This study estimates longitudinal trends in the prevalence and treatment of depression among adults in the United States with and without cancer.
This cross-sectional study focused on adults aged 20 years or older based on nationally representative data from the National Health and Nutrition Examination Surveys 2005-2020. Weighted logistic regression model was established to assess association between depression and cancer status after adjusting various covariates potentially related to depression.
Among the 37,283 participants (weighted mean age, 47.5; women, 50.9 %), 3648 (9.8 %) were diagnosed with cancer and 3343 (9.0 %) were screened positive for depression. The age-standardized prevalence of depression showed a U-shaped trend in cancer survivors, decreasing from 11.8 % (95 % confidence interval, 8.4 %-15.2 %) in 2005-2008 to 8.3 % (5.6 %-11.0 %) in 2013-2016, then increasing to 11.7 % (6.3 %-17.2 %) in 2017-2020. These trends varied by population subgroup. Among depressive patients with cancer, antidepressant use increased from 38.6 % (28.7 %-48.5 %) in 2005-2008 to 62.9 % (40.6 %-85.2 %) in 2017-2020, whereas mental health consultation increased slightly.
Using a screening questionnaire instead of diagnostic criteria to identify depression; small sample size of patients with cancer; and cross-sectional analysis without prospective outcomes.
From 2005 to 2020, the depression disease burden in patients with cancer eased in 2009-2015, but deteriorated recently. A healthy lifestyle and reasonable treatment for depression, based on an objective examination of depression characteristics, would improve long-term cancer outcomes and quality of life.
了解癌症幸存者抑郁的趋势特征对于医疗保健政策和规划至关重要。本研究旨在估计美国有和没有癌症的成年人中抑郁的患病率和治疗的纵向趋势。
本横断面研究基于全国代表性的 2005-2020 年国家健康和营养调查数据，关注年龄在 20 岁及以上的成年人。建立加权逻辑回归模型，以调整与抑郁相关的各种潜在混杂因素后，评估抑郁与癌症状况之间的关联。
在 37283 名参与者中（加权平均年龄 47.5 岁，女性占 50.9%），3648 人（9.8%）被诊断患有癌症，3343 人（9.0%） screened positive for depression。癌症幸存者中抑郁的年龄标准化患病率呈 U 型趋势，从 2005-2008 年的 11.8%（95%置信区间，8.4%-15.2%）降至 2013-2016 年的 8.3%（5.6%-11.0%），然后在 2017-2020 年升至 11.7%（6.3%-17.2%）。这些趋势因人群亚组而异。在患有癌症的抑郁患者中，抗抑郁药的使用率从 2005-2008 年的 38.6%（28.7%-48.5%）上升至 2017-2020 年的 62.9%（40.6%-85.2%），而心理健康咨询略有增加。
使用筛选问卷而不是诊断标准来识别抑郁；癌症患者的样本量小；以及没有前瞻性结果的横断面分析。
从 2005 年到 2020 年，癌症患者的抑郁疾病负担在 2009-2015 年有所缓解，但最近又恶化了。基于对抑郁特征的客观检查，采取健康的生活方式和合理的抑郁治疗方法，将改善长期的癌症结局和生活质量。
