Depression Before and After a Diagnosis of Pancreatic Cancer Results From a National, Population-Based Study
Depression Before and After a Diagnosis of Pancreatic Cancer Results From a National, Population-Based Study
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DOI：
10.1097/mpa.0000000000001635
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发表时间：
2020-09-01
期刊：
影响因子：
2.9
通讯作者：
Thakkar, Shyam
中科院分区：
文献类型：
--
作者：
Seoud, Talal;Syed, Aslam;Thakkar, Shyam
目的本研究的目的是评估抑郁症的胰腺癌（PC）患者之前和之后的癌症诊断使用美国的医疗保健数据库。我们还试图研究PC患者抑郁治疗对全因死亡率的影响。方法将Explorys（1999 - 2019）中伴抑郁症的胰腺癌患者与对照组进行比较，使用比值比和95%置信区间。记录在PC诊断之前和之后6个月、1年和3年内诊断的抑郁症的发生率。在PC诊断后发生抑郁症的患者被进一步分类为使用心理健康专业人员（MHP），药物治疗或两者（2015 - 2019）治疗抑郁症的患者。结果62,450例PC患者中，PC前有10,220例（16.4%）抑郁，PC后有8130例（13%）抑郁。PC后诊断为抑郁症的患者的全因死亡率显著高于单纯PC患者（P <0.0001）。MHP的参与显著改善了全因死亡率（P = 0.0041）。结论大多数PC后抑郁症在PC诊断后的前6个月内被诊断。虽然抑郁症显着增加PC死亡率，整合MHP在PC抑郁症患者的护理改善的结果。
Objectives The aim of this study was to evaluate depression in pancreatic cancer (PC) patients before and after a cancer diagnosis using a US-based healthcare database. We also sought to study the impact of treatment of depression in PC patients on all-cause mortality. Methods Pancreatic cancer patients with comorbid depression in Explorys (1999-2019) were compared with controls using odds ratios with 95% confidence intervals. Rates of depression diagnosed within 6 months, 1 year, and 3 years before and after a PC diagnosis were recorded. Patients who developed depression after a PC diagnosis were further categorized into those treated for depression using mental health professionals (MHPs), pharmacologic treatment, or both (2015-2019). Results Of the 62,450 PC patients, 10,220 (16.4%) were diagnosed with depression before PC and 8130 (13%) were diagnosed with depression after PC. Patients diagnosed with depression after PC had a significantly higher all-cause mortality than patients with PC alone (P< 0.0001). Involvement of MHP significantly improved all-cause mortality (P= 0.0041). Conclusions Most post-PC depression is diagnosed in the first 6 months after a PC diagnosis. Although depression significantly increases PC mortality, integrating MHP in the care of PC patients with depression improves outcomes.