Risk of depressive symptoms before and after the first hospitalisation for cancer: Evidence from a 16-year cohort study in the Czech Republic.
Risk of depressive symptoms before and after the first hospitalisation for cancer: Evidence from a 16-year cohort study in the Czech Republic.
复制标题
首次因癌症住院前后出现抑郁症状的风险：来自捷克共和国一项 16 年队列研究的证据。
DOI：
10.1016/j.jad.2020.06.070
复制
发表时间：
2020
影响因子：
6.6
通讯作者：
Bobak,Martin
中科院分区：
文献类型：
--
作者：
Lu,Wentian;Pikhart,Hynek;Peasey,Anne;Kubinova,Ruzena;Pitman,Alexandra;Bobak,Martin
背景抑郁症风险是否在癌症诊断之前就开始增加，以及癌症是否是抑郁症的独立危险因素，目前尚不清楚。我们的目的是量化的风险，抑郁症状之前和之后的第一次住院治疗癌症（作为癌症诊断的代理）之间的patients with cancer.MethodsWe链接队列数据与国家在捷克共和国的住院记录。我们对1056例癌症病例进行了长达15年的随访，包括第一次癌症住院前和第一次癌症住院后的15年。使用流行病学抑郁症中心（CES-D）量表测量抑郁症状。我们使用多层次有序逻辑回归来评估随访时间（住院前和住院后）与癌症病例中抑郁症状之间的关系。倾向评分匹配每一个案件与癌症的控制，测试独立的影响，随着时间的推移，癌症对抑郁症symptoms.ResultsPer一年的后续行动（无论是前或后住院）与1.07（1.05-1.10）倍更有可能有高的严重程度，抑郁症患者之间的癌症。患有严重抑郁症状的概率从住院前5年的25%增加到住院后7.5年的33%。在匹配的无癌对照之间的平行分析中，抑郁症状的风险在随访期间没有显着变化。LimitationsStratified基于癌症类型和恶性肿瘤分期的分析是不可行的。使用无癌症的匹配对照，我们证实癌症是抑郁症状的独立预测因子。
BackgroundWhether depression risk starts increasing before cancer diagnosis, and whether cancer is an independent risk factor for depression, remain unclear. We aimed to quantify the risk of depressive symptoms before and after the first hospitalisation for cancer (as a proxy for cancer diagnosis) amongst patients with cancer.MethodsWe linked cohort data with national hospitalisation records in the Czech Republic. We followed 1056 incident cancer cases for up to 15 years before and 15 years after the first hospitalisation for cancer. Depressive symptoms were measured using the Centre for Epidemiological Studies-Depression (CES-D) scale. We used multilevel ordered logistic regression to assess the relationship between follow-up years (pre- and post-hospitalisation) and depressive symptoms amongst incident cancer cases. Propensity Score Matching was employed to match each case with a cancer-free control, to test the independent effect of cancer on depressive symptoms over time.ResultsPer one year of follow-up (whether pre- or post- hospitalisation) was associated with 1.07 (1.05–1.10) times more likely to have high severity of depressive symptoms amongst patients with cancer. The probability of having high severity of depressive symptoms increased from 25% at five years before hospitalisation to 33% at 7.5 years after hospitalisation. In parallel analyses amongst matched cancer-free controls, the risk of depressive symptoms had no significant changes during follow-up.LimitationsStratified analyses based on cancer types and stages of malignancy were infeasible.ConclusionsThe excess risk of depressive symptoms was apparent five years prior to the first hospitalisation for cancer. Using cancer-free matched controls, we confirmed that cancer was an independent predictor of depressive symptoms.