Wang Wen-Xuan, Wu Yi-Shan, Qi Li-Ping, Wu Anise M S, Zhu Ying-Ying, Gong Wei-Jie, Guo Shan-Shan, Hua Yi-Jun, Luo Dong-Hua, Chen Qiu-Yan, Xiang Yan-Qun, Zhang Jin-Xin, Mai Hai-Qiang, Li Ji-Bin
School of Public Health, Sun Yat-sen University, Guangzhou, China.
Department of Clinical Research, Sun Yat-sen University Cancer Center, Guangzhou, China.
Front Public Health. 2024 Dec 3;12:1469001. doi: 10.3389/fpubh.2024.1469001. eCollection 2024.
Despite advancements in cancer treatment, understanding the long-term mental health implications for nasopharyngeal carcinoma (NPC) survivors remains an underexplored area. This study aims to examine the prevalence of mental disorders and their correlations with age at diagnosis and time since diagnosis among NPC survivors.
A total of 1872 NPC patients were surveyed from September 2020 to June 2021 in this cross-sectional survey. Logistic regression models were used to analyze the associations of age at diagnosis and time since NPC diagnosis with the risk of mental disorders. Additionally, the potential nonlinear trend between these factors was examined using restricted cubic splines. Analyses were conducted both overall and stratified by gender. Gender interaction was also examined.
The prevalences of depression, anxiety, and sleep disorders were 32.4, 33.2, and 61.5%, respectively. Age at NPC diagnosis was significantly associated with an elevated risk of depression (adjusted OR (aOR): 1.75 for 30-39 years old; 2.33 for 50-59 years old; 2.59 for ≥60 years old) and sleep disorders (aOR: 2.41 for 40-49 years old; 1.95 for 50-59 years old; 2.26, for ≥60 years old), compared to patients diagnosed with NPC at age < 30 years. Conversely, the risk of depression, anxiety, and sleep disorders exhibited negative associations with the time since diagnosis, compared to patients <3 months. Notably, significant nonlinear associations were observed between time since diagnosis and the risk of depression, anxiety, and sleep disorders, which showed an initial increase, with the highest risk occurring at approximately 3.0 (OR: 2.7), 1.5 (OR: 2.1), and 4.0 (OR: 1.9) months since NPC diagnosis, followed by a gradual recovery to a lower risk level at around 12 months. No gender interactions were observed.
The prevalence of mental disorders is notable among NPC survivors, showing a positive correlation with age at diagnosis while displaying a negative correlation with time since diagnosis, thus indicating the need for psychological support, especially within the initial several months following NPC diagnosis.
尽管癌症治疗取得了进展,但对于鼻咽癌(NPC)幸存者长期心理健康影响的了解仍然是一个未被充分探索的领域。本研究旨在调查NPC幸存者中精神障碍的患病率及其与诊断时年龄和诊断后时间的相关性。
在2020年9月至2021年6月的这项横断面调查中,共对1872例NPC患者进行了调查。使用逻辑回归模型分析诊断时年龄和NPC诊断后时间与精神障碍风险的关联。此外,使用受限立方样条检验这些因素之间的潜在非线性趋势。分析在总体上以及按性别分层进行。还检验了性别交互作用。
抑郁、焦虑和睡眠障碍的患病率分别为32.4%、33.2%和61.5%。与诊断时年龄<30岁的NPC患者相比,NPC诊断时的年龄与抑郁风险升高显著相关(调整后比值比(aOR):30 - 39岁为1.75;50 - 59岁为2.33;≥60岁为2.59)以及睡眠障碍(aOR:40 - 49岁为2.41;50 - 59岁为1.95;≥60岁为2.26)。相反,与诊断后<3个月的患者相比,抑郁、焦虑和睡眠障碍的风险与诊断后的时间呈负相关。值得注意的是,在诊断后时间与抑郁、焦虑和睡眠障碍风险之间观察到显著的非线性关联,其显示出最初上升,在NPC诊断后约3.0(OR:2.7)、1.5(OR:2.1)和4.0(OR:1.9)个月时风险最高,随后在约12个月时逐渐恢复到较低风险水平。未观察到性别交互作用。
NPC幸存者中精神障碍的患病率值得关注,与诊断时年龄呈正相关,而与诊断后的时间呈负相关,因此表明需要心理支持,特别是在NPC诊断后的最初几个月内。