Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charité Comprehensive Cancer Center, Berlin.
Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany (CCCG), University Medical Center Leipzig, Leipzig.
ESMO Open. 2024 Aug;9(8):103655. doi: 10.1016/j.esmoop.2024.103655. Epub 2024 Jul 31.
The purpose of this study was to provide the 4-week prevalence estimates of mental disorders in newly diagnosed cancer patients in relation to socioeconomic status (SES).
We enrolled newly diagnosed patients with a confirmed solid tumor within 2 months of diagnosis. We calculated patients' SES on the basis of their educational level, professional qualification, income and occupational status. We used the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition-Clinical Version (SCID-5-CV) to assess the 4-week prevalence of mental disorders in addition to a comorbidity questionnaire to assess the level of physical impairment.
We identified a total of 1702 patients with mixed cancers after reviewing their medical records and contacting them in person or by post due to coronavirus pandemic patient safety restrictions. 1030 patients (53.2% men, mean age 60.2 years) had completed SCID-5-CV. When weighted according to the SES distribution to account for over- and under-sampling of SES groups, 20.9% [95% confidence interval (CI) 18.1% to 23.6%] of patients were diagnosed with any mental disorder. The most prevalent were depressive disorders (9.9%, 95% CI 7.9% to 11.9%), trauma and stress-related disorders (6.3%, 95% CI 4.7% to 7.9%) and anxiety disorders (4.2%, 95% CI 2.9% to 5.6%). We found no difference in any mental disorder between patients with high, medium or low SES. Multivariate logistic regression analyses revealed higher proportion of patients with any mental disorder in patients younger than 60 years [odds ratio (OR) 0.42; P < 0.001], in patients without a partner (OR 1.84; P < 0.001), in women with tumor in female genital organs (OR 2.45; P < 0.002) and in those with a higher level of impairment (OR 1.05, 95% CI 1.03-1.07; P < 0.001).
SES had no significant influence on mental comorbidity in early cancer survivorship.
本研究旨在提供新诊断癌症患者中与社会经济地位(SES)相关的精神障碍四周患病率估计值。
我们纳入了确诊时间在诊断后 2 个月内的确诊实体瘤新患者。我们根据患者的教育程度、专业资格、收入和职业状况来计算 SES。我们使用诊断和统计手册精神障碍,第五版-临床版(SCID-5-CV)的结构临床访谈来评估除共病问卷外,精神障碍的四周患病率,以评估身体损伤程度。
我们共评估了 1702 名混合癌症患者的病历,并由于冠状病毒大流行期间患者安全限制,亲自或通过邮寄联系了他们。1030 名患者(53.2%为男性,平均年龄为 60.2 岁)完成了 SCID-5-CV。根据 SES 分布进行加权,以说明 SES 组的过度和抽样不足,20.9%[95%置信区间(CI)18.1%至 23.6%]的患者被诊断为患有任何精神障碍。最常见的是抑郁障碍(9.9%,95%CI7.9%至 11.9%)、创伤和应激相关障碍(6.3%,95%CI4.7%至 7.9%)和焦虑障碍(4.2%,95%CI2.9%至 5.6%)。我们没有发现 SES 较高、中、低的患者之间存在任何精神障碍差异。多变量逻辑回归分析显示,60 岁以下的患者、无伴侣的患者(OR1.84;P<0.001)、女性生殖器官肿瘤患者(OR2.45;P<0.002)和身体损伤程度较高的患者(OR1.05,95%CI1.03-1.07;P<0.001)有更高比例的任何精神障碍患者。
SES 对早期癌症生存者的精神共病没有显著影响。