Depression and anxiety in long-term cancer survivors compared with spouses and healthy controls: a systematic review and meta-analysis
Depression and anxiety in long-term cancer survivors compared with spouses and healthy controls: a systematic review and meta-analysis
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DOI：
10.1016/s1470-2045(13)70244-4
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发表时间：
2013-07-01
期刊：
影响因子：
51.1
通讯作者：
Symonds, Paul
中科院分区：
文献类型：
--
作者：
Mitchell, Alex J.;Ferguson, David W.;Symonds, Paul
背景在过去的20年里，癌症生存率有所提高，影响了情绪障碍的长期风险。我们评估是否抑郁和焦虑是更常见的癌症的长期幸存者与他们的配偶和健康controls.Methods相比，我们系统地搜索Medline，PsycINFO，Embase，科学直接，Ingenta选择，奥维德，和威利Interscience的报告，情绪障碍的患病率在至少2年前诊断为癌症的患者。我们还检索了国际心理肿瘤学会的记录和引用相关参考文献的报告。三名研究者独立提取原始数据。我们做了一个随机效应荟萃分析的癌症患者的抑郁症和焦虑症的患病率与配偶和健康controls.Findings我们的搜索返回144个结果，43个被列入主要分析：与健康对照组相比，16个评估抑郁症和10个评估焦虑;与配偶的比较，12个评估抑郁症和5个评估焦虑。在51381名癌症幸存者的合并样本中，抑郁症的患病率为11.6%（95%CI 7.7-16.2），在217630名健康对照者中为10.2%（8.0-12.6）（合并相对风险[RR] 1.11，95%CI 0.96-1.27; p=0.17）。48964名癌症幸存者的焦虑患病率为17.9%（95%CI 12.8-23.6），226467名健康对照者的焦虑患病率为13.9%（9.8-18.5）（RR 1.27，95%CI 1.08-1.50; p=0.0039）。抑郁症的流行率（26.7% vs 26.3%; RR 1.01，95% CI 0.86-1.20; p=0.88），焦虑的患病率也没有（28.0%vs 40.1%，RR 0.71，95%CI 0.44-1.14; p=0.16）在癌症患者和他们的配偶之间差异显著。解释我们的研究结果表明，焦虑，而不是抑郁，与健康对照组相比，长期癌症幸存者和配偶最有可能出现问题。应努力提高对长期癌症幸存者及其配偶焦虑的认识和治疗。
Background Cancer survival has improved in the past 20 years, affecting the long-term risk of mood disorders. We assessed whether depression and anxiety are more common in long-term survivors of cancer compared with their spouses and with healthy controls.Methods We systematically searched Medline, PsycINFO, Embase, Science Direct, Ingenta Select, Ovid, and Wiley Interscience for reports about the prevalence of mood disorders in patients diagnosed with cancer at least 2 years previously. We also searched the records of the International Psycho-oncology Society and for reports that cited relevant references. Three investigators independently extracted primary data. We did a random-effects meta-analysis of the prevalences of depression and anxiety in cancer patients compared with spouses and healthy controls.Findings Our search returned 144 results, 43 were included in the main analysis: for comparisons with healthy controls, 16 assessed depression and ten assessed anxiety; of the comparisons with spouses, 12 assessed depression and five assessed anxiety. The prevalence of depression was 11.6% (95% CI 7.7-16.2) in the pooled sample of 51 381 cancer survivors and 10.2% (8.0-12.6) in 217 630 healthy controls (pooled relative risk [RR] 1.11, 95% CI 0.96-1.27; p=0.17). The prevalence of anxiety was 17.9% (95% CI 12.8-23.6) in 48 964 cancer survivors and 13.9% (9.8-18.5) in 226 467 healthy controls (RR 1.27, 95% CI 1.08-1.50; p=0.0039). Neither the prevalence of depression (26.7% vs 26.3%; RR 1.01, 95% CI 0.86-1.20; p=0.88) nor the prevalence of anxiety (28.0% vs 40.1%; RR 0.71, 95% CI 0.44-1.14; p=0.16) differed significantly between cancer patients and their spouses.Interpretation Our findings suggest that anxiety, rather than depression, is most likely to be a problem in long-term cancer survivors and spouses compared with healthy controls. Efforts should be made to improve recognition and treatment of anxiety in long-term cancer survivors and their spouses.