Singer Susanne, Schranz Melanie, Hippler Melina, Kuchen Robert, Weiß Lucas Carolin, Meixensberger Jürgen, Fehrenbach Michael Karl, Keric Naureen, Mitsdoerffer Meike, Gempt Jens, Coburger Jan, Kessler Almuth Friederike, Wehinger Jens, Misch Martin, Onken Julia, Rapp Marion, Voß Martin, Nadji-Ohl Minou, Mehlitz Marcus, Tatagiba Marcos, Tabatabai Ghazaleh, Renovanz Mirjam
Institute of Medical Biostatistics, Epidemiology, and Informatics, University Medical Center, Mainz, Germany.
University Cancer Center, University Medical Center, Mainz, Germany.
Cancer. 2025 Jan 1;131(1):e35653. doi: 10.1002/cncr.35653. Epub 2024 Nov 17.
One third of adults with cancer suffer from common mental disorders in addition to their malignant disease. However, it is unknown whether this proportion is the same in patients who have brain tumors and which factors modulate the risk for psychiatric comorbidity.
In a multicenter study, patients with high-grade glioma at 13 neurooncology clinics were enrolled consecutively and interviewed with the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (SCID) to diagnose common mental disorders. Predictors of psychiatric comorbidity were investigated using binary logistic regression.
Six hundred ninety-one patients were interviewed. The proportion of patients who had mental disorders was 31% (95% confidence interval [CI], 28%-35%). There was evidence for an association of psychiatric comorbidity with the following factors: younger age (odds ratio [OR], 1.9; 95% CI, 1.1-3.4; p = .04), stable disease versus complete remission (OR, 1.7; 95% CI, 1.1-2.8; p = .04), lower income (OR, 1.7; 95% CI, 1.0-2.8; p = .04), living alone (OR, 1.6; 95% CI, 1.0-2.6; p = .05), fatigue (OR, 1.6; 95% CI, 1.1-2.4; p = .03), and impaired cognitive functioning (OR, 2.3; 95% CI, 1.5-3.6; p < .01). There was no evidence for independent effects of gender, histology, affected lobe, time since diagnosis, or employment status.
Approximately one third of adult patients with high-grade glioma may suffer from a clinically relevant common mental disorder, without notable disparity between the genders. In particular, clinicians should pay attention to possible comorbidities for cases in which patients exhibit compromised subjective cognitive function, are younger than 50 years, maintain a state of stable disease, or live alone.
三分之一的成年癌症患者除患有恶性疾病外，还患有常见精神障碍。然而，脑肿瘤患者中这一比例是否相同以及哪些因素会调节精神疾病共病风险尚不清楚。
在一项多中心研究中，连续纳入了13家神经肿瘤诊所的高级别胶质瘤患者，并使用《精神疾病诊断与统计手册》结构化临床访谈（SCID）进行访谈，以诊断常见精神障碍。使用二元逻辑回归研究精神疾病共病的预测因素。
共访谈了691名患者。患有精神障碍的患者比例为31%（95%置信区间[CI]，28%-35%）。有证据表明精神疾病共病与以下因素相关：年龄较小（比值比[OR]，1.9；95%CI，1.1-3.4；p = 0.04）、病情稳定与完全缓解（OR，1.7；95%CI，1.1-2.8；p = 0.04）、收入较低（OR，1.7；95%CI，1.0-2.8；p = 0.04）、独居（OR，1.6；95%CI，1.0-2.6；p = 0.05）、疲劳（OR，1.6；95%CI，1.1-2.4；p = 0.03）以及认知功能受损（OR，2.3；95%CI，1.5-3.6；p < 0.01）。没有证据表明性别、组织学、受累脑叶、诊断后时间或就业状况有独立影响。
大约三分之一的成年高级别胶质瘤患者可能患有具有临床意义的常见精神障碍，性别之间无明显差异。特别是，临床医生应关注患者主观认知功能受损、年龄小于50岁、病情稳定或独居的病例中可能存在的共病情况。
