Ouh Yung-Taek, Kim Eun-Yeob, Kim Nam Kyeong, Lee Nak-Woo, Min Kyung-Jin
Department of Obstetrics and Gynecology, Korea University Ansan Hospital, Ansan-si 15355, Gyeonggi-do, Republic of Korea.
Department of Medical Science Research Center, Korea University Ansan Hospital, Ansan-si 15355, Gyeonggi-do, Republic of Korea.
Healthcare (Basel). 2025 Aug 5;13(15):1904. doi: 10.3390/healthcare13151904.
This study aimed to investigate the impact of depression and anxiety disorders on mortality in women diagnosed with gynecologic cancers, utilizing nationwide retrospective cohort data.
Data from the Korean National Health Insurance Service (NHIS) database, covering women diagnosed with cervical, endometrial, or ovarian cancers between 2007 and 2014, were analyzed. Women diagnosed with depression or anxiety disorders within one year after cancer diagnosis were identified and compared with a control group comprising patients with gynecologic cancers who did not develop either disorder during the same post-diagnosis period. Mortality was evaluated as the primary outcome.
Of 85,327 women analyzed, 784 (0.9%) were diagnosed with depression or anxiety disorders. Patients with depression or anxiety exhibited significantly higher mortality (38.4% vs. 29.9%; < 0.001). Multivariate analysis indicated that depression significantly increased mortality risk (OR 1.46, 95% CI 1.27-1.66), whereas anxiety alone showed no significant effect (OR 0.97, 95% CI 0.74-1.27). Combined depression and anxiety showed the highest mortality risk (OR 1.47, 95% CI 1.31-1.65).
Depression and anxiety disorders are significant predictors of increased mortality in women with gynecologic cancers, emphasizing the necessity for integrated mental health assessment and interventions in oncologic care to improve both survival and quality of life.
本研究旨在利用全国性回顾性队列数据，调查抑郁症和焦虑症对被诊断为妇科癌症的女性死亡率的影响。
分析了韩国国民健康保险服务（NHIS）数据库中2007年至2014年间被诊断为宫颈癌、子宫内膜癌或卵巢癌的女性数据。确定在癌症诊断后一年内被诊断为抑郁症或焦虑症的女性，并与一个对照组进行比较，该对照组由在相同诊断后时期未患这两种疾病的妇科癌症患者组成。将死亡率作为主要结局进行评估。
在分析的85327名女性中，784名（0.9%）被诊断为抑郁症或焦虑症。患有抑郁症或焦虑症的患者死亡率显著更高（38.4%对29.9%；<0.001）。多变量分析表明，抑郁症显著增加死亡风险（OR 1.46，95%CI 1.27 - 1.66），而单独的焦虑症未显示出显著影响（OR 0.97，95%CI 0.74 - 1.27）。抑郁症和焦虑症合并出现时死亡风险最高（OR 1.47，95%CI 1.31 - 1.65）。
抑郁症和焦虑症是妇科癌症女性死亡率增加的重要预测因素，强调在肿瘤护理中进行综合心理健康评估和干预以提高生存率和生活质量的必要性。
