A cohort study on mental disorders, stage of cancer at diagnosis and subsequent survival.
A cohort study on mental disorders, stage of cancer at diagnosis and subsequent survival.
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DOI：
10.1136/bmjopen-2013-004295
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发表时间：
2014-01-29
期刊：
影响因子：
2.9
通讯作者：
Stewart R
中科院分区：
文献类型：
--
作者：
Chang CK;Hayes RD;Broadbent MT;Hotopf M;Davies E;Møller H;Stewart R
评估接受二级精神卫生服务的人与其他当地人相比，在癌症诊断和癌症诊断后的生存阶段。使用匿名联系的区域垄断二级精神卫生服务提供商在东南伦敦的四个伦敦行政区，克罗伊登，兰贝斯，刘易舍姆和南华克，以人口为基础的癌症登记，历史队列研究。共确定了28477例年龄在15岁以上的癌症病例，诊断时记录了癌症分期。 其中，2206名参与者在癌症诊断之前曾在二级精神保健中接受过评估或治疗，125名参与者患有严重精神疾病（精神分裂症，情感障碍或双相情感障碍）。在伦敦东南部地区登记的癌症病例中，癌症诊断的阶段和癌症诊断后的全因死亡率。采用Logistic和考克斯模型对同一居住区有和无特定精神病诊断的人在诊断时晚期癌症的风险和癌症诊断后的总体生存率进行比较。没有发现特定的精神障碍诊断与癌症的局部扩散之间的联系。然而，患有严重精神障碍，抑郁症，痴呆症和物质使用障碍的人在癌症诊断后的生存率明显更差，与诊断时的癌症分期和其他潜在的混杂因素无关。先前关于精神障碍和癌症死亡率之间的关联的发现更可能是由于癌症诊断后生存率的差异，而不是延迟诊断。
To assess the stage at cancer diagnosis and survival after cancer diagnosis among people served by secondary mental health services, compared with other local people. Using the anonymised linkage between a regional monopoly secondary mental health service provider in southeast London of four London boroughs, Croydon, Lambeth, Lewisham and Southwark, and a population-based cancer register, a historical cohort study was constructed. A total of 28 477 cancer cases aged 15+ years with stage of cancer recorded at diagnosis were identified. Among these, 2206 participants had been previously assessed or treated in secondary mental healthcare before their cancer diagnosis and 125 for severe mental illness (schizophrenia, schizoaffective or bipolar disorders). Stage when cancer was diagnosed and all-cause mortality after cancer diagnosis among cancer cases registered in the geographical area of southeast London. Comparisons between people with and without specific psychiatric diagnosis in the same residence area for risks of advanced stage of cancer at diagnosis and general survival after cancer diagnosed were analysed using logistic and Cox models. No associations were found between specific mental disorder diagnoses and beyond local spread of cancer at presentation. However, people with severe mental disorders, depression, dementia and substance use disorders had significantly worse survival after cancer diagnosis, independent of cancer stage at diagnosis and other potential confounders. Previous findings of associations between mental disorders and cancer mortality are more likely to be accounted for by differences in survival after cancer diagnosis rather than by delayed diagnosis.
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影响因子：
4.5
作者：
Cohen, ME;Dembling, B;Schorling, JB
通讯作者：
Schorling, JB
影响因子：
2.4
作者：
Attner, Bo;Lithman, Thor;Olsson, Hakan
通讯作者：
Olsson, Hakan
影响因子：
8.8
作者：
Batty, G. D.;Whitley, E.;Rasmussen, F.
通讯作者：
Rasmussen, F.
DOI：
10.2190/0c63-u15v-5nur-tvxe
发表时间：
1999-01-01
影响因子：
2
作者：
Desai, MM;Bruce, ML;Kasl, SV
通讯作者：
Kasl, SV
影响因子：
4.5
作者：
Grinshpoon, A;Barchana, M;Levav, I
通讯作者：
Levav, I