Psychological distress and cancer mortality
Psychological distress and cancer mortality
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DOI：
10.1016/j.jpsychores.2008.11.002
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发表时间：
2009-03-01
影响因子：
4.7
通讯作者：
Molloy, Gerard J.
中科院分区：
文献类型：
--
作者：
Hamer, Mark;Chida, Yoichi;Molloy, Gerard J.
背景：心理困扰，如持续的抑郁和焦虑相关的症状，与癌症发生的风险和较差的存活率相关，尽管以前的研究没有在同一样本中比较预后和病因的影响。我们研究了心理痛苦和癌症死亡率之间的关系，样本包括有和没有癌症入院经历的参与者。方法：数据收集自基于社区的15453名男性和女性样本(包括295名有癌症病史的人)，并前瞻性地链接到以患者为基础的癌症登记数据库和平均随访7.0+/-3.3年期间的死亡人数。使用一般健康问卷(GHQ-12)的12个条目版本评估心理苦恼。结果：共有425例癌症死亡事件。在有癌症病史[年龄、性别、社会状况、婚姻状况、体重指数、吸烟、饮酒和体力活动；调整后的危险比(HR)=1.97；95%可信区间(95%CI)1.05-3.71；P=.0351]的参与者中，心理困扰(GHQ-12>；=4)与癌症死亡率的增加有关，但在没有癌症病史的参与者中不相关。然而，在没有癌症病史的参与者中，痛苦和肺癌死亡之间存在关联(年龄和性别调整后的HR为2.04；95%CI=1.36-3.0；P=.001)，尽管调整协变量后这种关联减弱。结论：心理痛苦是癌症死亡率的预测因子，尤其是肺癌患者。社区队列中有癌症病史的参与者可能高估了心理痛苦和随后的癌症死亡率之间的联系。(C)2009 Elsevier Inc.保留所有权利。
Background: Psychological distress, such as ongoing depression and anxiety-related symptomatology, has been associated with a higher risk of incident cancer and poorer survival, although previous studies have not compared prognostic and etiological effects within the same sample. We examined the association between psychological distress and cancer mortality in a sample comprising participants with and Without previous cancer admissions. Methods: Data were collected from a community-based sample of 15,453 men and women (including 295 people with cancer history) and prospectively linked to a patient-based database of cancer registry and deaths during an average follow-up of 7.0 +/- 3.3 years. Psychological distress was assessed using the 12-item version of the General Health Questionnaire (GHQ-12). Results: There were 425 incident cancer deaths. Psychological distress (GHQ-12 >= 4) was associated with increased cancer mortality in participants with cancer history [age, gender, social status, marital status, body mass index, smoking, alcohol, and physical activity; adjusted hazard ratio (HR)=1.97; 95% confidence interval (95% Cl) 1.05-3.71; P=.0351, but not in participants without cancer history. Among participants without cancer history, there was, however, an association between distress and lung cancer death (age- and gender-adjusted HR 2.04; 95% CI=1.36-3.0; P=.001), although adjustment for covariates attenuated this association. Conclusions: Psychological distress was a predictor of cancer mortality, especially in lung cancer. The presence of participants with cancer history in community-based cohorts may overestimate the association between psychological distress and subsequent cancer mortality. (c) 2009 Elsevier Inc. All rights reserved.