Howell Jackson N, Mark Bayarmaa, Wada David A, Bowling Marianne, Wei Mei, Lloyd Shane L, Gaffney David K, Maity Amit, LaRiviere Michael J, Rule William G, Grant Jon D, Deshmukh Vikrant, Newman Michael, Date Ankita, Hashibe Mia, Tao Randa
Huntsman Cancer Institute, Salt Lake City, Utah, USA.
Department of Radiation Oncology, University of Utah School of Medicine, Salt Lake City, Utah, USA.
Cancer Med. 2025 Mar;14(5):e70577. doi: 10.1002/cam4.70577.
We investigated mental health diagnoses (MHDs) in mycosis fungoides (MF) patients compared to the general population, evaluated risk factors, and studied survival outcomes in a large population database.
MF patients from the Utah Cancer Registry diagnosed from 2001 to 2014 were matched with up to five general population individuals from the Utah Population Database. MHDs were retrospectively tracked in both populations (median follow-up = 6.67 years). Risk factors for new MHDs among MF patients were studied using the Cox proportional hazards model. Overall survival (OS) and disease-specific survival (DSS) were assessed using Kaplan-Meier analysis.
The incidence of anxiety disorders (HR = 1.99, 95% CI [1.16, 3.42]) and delirium/dementia disorders (HR = 2.43, 95% CI [1.05, 5.63]) was higher among MF patients than the matched general population. Among MF patients, Charlson Comorbidity Index (CCI) ≥ 2 and BMI < 18 kg/m were risk factors for new anxiety disorders. Radiation therapy, CCI ≥ 2, and female gender were risk factors for new delirium/dementia disorders. The 15-year OS was worse for MF patients with versus without an MHD (36% vs. 81%, HR 2.62, 95%CI [1.24, 5.65]). The 15-year DSS also worsened for MF patients with versus without an MHD (63% vs. 97%, HR 6.55, 95%CI [1.64, 26.2]).
MF patients developed anxiety and delirium/dementia disorders at rates above the general population, and MHDs correlated with worse DSS and OS. Careful mental health monitoring may be an actionable step towards improving health-related quality of life in this population.
我们在一个大型人群数据库中，对蕈样肉芽肿（MF）患者与普通人群的心理健康诊断（MHD）进行了调查，评估了风险因素，并研究了生存结果。
将2001年至2014年犹他州癌症登记处诊断的MF患者与犹他州人口数据库中最多5名普通人群个体进行匹配。对这两个人群的MHD进行回顾性跟踪（中位随访时间 = 6.67年）。使用Cox比例风险模型研究MF患者中新发MHD的风险因素。采用Kaplan-Meier分析评估总生存期（OS）和疾病特异性生存期（DSS）。
MF患者中焦虑症（HR = 1.99，95%CI [1.16, 3.42]）和谵妄/痴呆症（HR = 2.43，95%CI [1.05, 5.63]）的发病率高于匹配的普通人群。在MF患者中，Charlson合并症指数（CCI）≥2和体重指数（BMI）<18 kg/m²是新发焦虑症的风险因素。放射治疗、CCI≥2和女性性别是新发谵妄/痴呆症的风险因素。有MHD的MF患者15年总生存期比无MHD的患者更差（36%对81%，HR 2.62，95%CI [1.24, 5.65]）。有MHD的MF患者15年疾病特异性生存期也比无MHD的患者更差（63%对97%，HR 6.55，95%CI [1.64, 26.2]）。
MF患者发生焦虑症和谵妄/痴呆症的几率高于普通人群，且MHD与较差的疾病特异性生存期和总生存期相关。仔细的心理健康监测可能是改善该人群健康相关生活质量的一个可行措施。
