Bird Meghan J, Li Grace, MacNeil Andie, Jiang Ying, de Groh Margaret, Fuller-Thomson Esme
Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada.
Institute for Life Course and Aging, University of Toronto, Toronto, ON, Canada.
Cancer Manag Res. 2023 Sep 6;15:937-955. doi: 10.2147/CMAR.S421675. eCollection 2023.
The objectives of this study were to identify the prevalence of, and factors associated with, incident and recurrent depression in a sample of older adults with a history of cancer during the COVID-19 pandemic.
Data were drawn from four waves of the Canadian Longitudinal Study on Aging Comprehensive Cohort (n=2486 with cancer). The outcome of interest was a positive screen for depression based on the CES-D-10 during the autumn of 2020.
Among older adults with cancer and no pre-pandemic history of depression (n=1765), 1 in 8 developed first onset depression during the pandemic. Among respondents with cancer and a history of depression (n=721), 1 in 2 experienced a recurrence of depression. The risk of both incident and recurrent depression was higher among those who were lonely, those with functional limitations, and those who experienced an increase in family conflict during the pandemic. The risk of incident depression only was higher among older women, those who did not engage in church or religious activities, those who experienced a loss of income during the pandemic, and those who became ill or had a loved one become ill or die during the pandemic. The risk of recurrent depression only was higher among those who felt isolated from others and those whose income did not satisfy their basic needs.
Health care providers should continue to screen and provide mental health support to their cancer patients and those with a lifetime history of cancer, with consideration for those with the aforementioned vulnerabilities.
本研究的目的是确定在COVID-19大流行期间,有癌症病史的老年人群中,新发和复发性抑郁症的患病率及其相关因素。
数据来自加拿大老龄化纵向研究综合队列的四轮调查(n = 2486名癌症患者)。感兴趣的结果是基于2020年秋季的CES-D-10抑郁筛查呈阳性。
在无大流行前抑郁症病史的癌症老年患者中(n = 1765),八分之一的人在大流行期间首次出现抑郁症。在有癌症病史且有抑郁症病史的受访者中(n = 721),二分之一的人经历了抑郁症复发。在大流行期间感到孤独、有功能障碍以及家庭冲突增加的人群中,新发和复发性抑郁症的风险更高。仅新发抑郁症的风险在老年女性、未参加教会或宗教活动的人群、在大流行期间收入减少的人群以及在大流行期间生病或有亲人患病或死亡的人群中更高。仅复发性抑郁症的风险在感到与他人隔绝以及收入无法满足基本需求的人群中更高。
医疗保健提供者应继续对癌症患者及其有终身癌症病史的人群进行筛查,并为他们提供心理健康支持,同时考虑到那些有上述脆弱性的人群。