Franziska Springer, Ute Goerling, Tanja Zimmermann, Jochen Ernst, Christoph Engel, Myriel Hermann, Peter Esser, Beate Hornemann, Ulrich Keilholz, Florian Lordick, Olaf von dem Knesebeck, David Kissane, Anja Mehnert-Theuerkauf
{"title":"早期癌症患者精神障碍病程与社会经济地位的关系：一项多中心前瞻性纵向研究（LUPE）。","authors":"Franziska Springer, Ute Goerling, Tanja Zimmermann, Jochen Ernst, Christoph Engel, Myriel Hermann, Peter Esser, Beate Hornemann, Ulrich Keilholz, Florian Lordick, Olaf von dem Knesebeck, David Kissane, Anja Mehnert-Theuerkauf","doi":"10.1002/pon.70059","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Individuals with low socioeconomic status (SES) exhibit higher rates of mental disorders; however, data in oncological populations are insufficient. This study investigated the course of DSM-5 mental disorders in cancer patients, stratified by SES, over a period of 1.5 years following initial cancer diagnosis.</p><p><strong>Methods: </strong>This multi-center prospective longitudinal study assessed cancer patients within two months of cancer diagnosis (t1), and at 6-, 12-, and 18-month follow-up (t2-t4) using the SCID-5 interview for mental disorders based on DSM-5 criteria. Chi-square-tests were tested for frequency changes over time. A generalized linear mixed model (GLMM) was applied with fixed effects for SES and time on mental disorders.</p><p><strong>Results: </strong>Out of 1030 patients with a SCID-5 at baseline (53.2% men, 60 years), 821, 719 and 654 participated at respective follow-ups. The most common diagnoses were skin and prostate cancer. Point prevalence of mental disorders was 20.9% at baseline, decreasing to 18.2%, 14.6%, and 15.0% (t2-t4; χ<sup>2</sup> (3) = 15.3, p = 0.002). Patients with low SES consistently showed highest prevalence rates, whereas patients with high SES showed decreasing rates of mental disorders over time, with a main effect of time (χ<sup>2</sup> (3) = 19.9, p < 0.001) and SES (χ<sup>2</sup> (2) = 8.8, p = 0.01) in the GLMM. Two thirds never met diagnostic criteria for a mental disorder. Sensitivity analysis among study completers (n = 592) revealed a similar pattern to the main analysis.</p><p><strong>Conclusions: </strong>Cancer patients with low SES exhibit impaired coping with cancer-related stressors, increasing their risk for mental disorders. Social disparities affect physical and mental health, possibly via health behavior or health literacy, and need to be addressed by tailored survivorship care planning.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 1","pages":"e70059"},"PeriodicalIF":3.3000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711303/pdf/","citationCount":"0","resultStr":"{\"title\":\"Course of Mental Disorders in Early Cancer Survivorship in Relation to Socioeconomic Status: A Multi-Center Prospective Longitudinal Study (LUPE).\",\"authors\":\"Franziska Springer, Ute Goerling, Tanja Zimmermann, Jochen Ernst, Christoph Engel, Myriel Hermann, Peter Esser, Beate Hornemann, Ulrich Keilholz, Florian Lordick, Olaf von dem Knesebeck, David Kissane, Anja Mehnert-Theuerkauf\",\"doi\":\"10.1002/pon.70059\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Individuals with low socioeconomic status (SES) exhibit higher rates of mental disorders; however, data in oncological populations are insufficient. This study investigated the course of DSM-5 mental disorders in cancer patients, stratified by SES, over a period of 1.5 years following initial cancer diagnosis.</p><p><strong>Methods: </strong>This multi-center prospective longitudinal study assessed cancer patients within two months of cancer diagnosis (t1), and at 6-, 12-, and 18-month follow-up (t2-t4) using the SCID-5 interview for mental disorders based on DSM-5 criteria. Chi-square-tests were tested for frequency changes over time. A generalized linear mixed model (GLMM) was applied with fixed effects for SES and time on mental disorders.</p><p><strong>Results: </strong>Out of 1030 patients with a SCID-5 at baseline (53.2% men, 60 years), 821, 719 and 654 participated at respective follow-ups. The most common diagnoses were skin and prostate cancer. Point prevalence of mental disorders was 20.9% at baseline, decreasing to 18.2%, 14.6%, and 15.0% (t2-t4; χ<sup>2</sup> (3) = 15.3, p = 0.002). Patients with low SES consistently showed highest prevalence rates, whereas patients with high SES showed decreasing rates of mental disorders over time, with a main effect of time (χ<sup>2</sup> (3) = 19.9, p < 0.001) and SES (χ<sup>2</sup> (2) = 8.8, p = 0.01) in the GLMM. Two thirds never met diagnostic criteria for a mental disorder. Sensitivity analysis among study completers (n = 592) revealed a similar pattern to the main analysis.</p><p><strong>Conclusions: </strong>Cancer patients with low SES exhibit impaired coping with cancer-related stressors, increasing their risk for mental disorders. 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引用次数: 0
摘要
目的：社会经济地位低的个体表现出较高的精神障碍发生率；然而，肿瘤人群的数据不足。本研究调查了DSM-5中癌症患者的精神障碍病程，按社会经济地位分层，在最初的癌症诊断后的1.5年内。方法：本多中心前瞻性纵向研究采用基于DSM-5标准的SCID-5精神障碍访谈，评估癌症患者在癌症诊断后2个月内（t1），以及6个月、12个月和18个月的随访（t2-t4）。卡方检验检验频率随时间的变化。采用广义线性混合模型（GLMM）对SES和时间对精神障碍的固定效应进行研究。结果：在1030名基线时患有SCID-5的患者中（53.2%为男性，60岁），分别有821、719和654名患者参加了随访。最常见的诊断是皮肤癌和前列腺癌。精神障碍的点患病率在基线时为20.9%，降至18.2%、14.6%和15.0% (t2-t4；χ2 (3) = 15.3, p = 0.002)。在GLMM中，低SES患者的患病率始终最高，而高SES患者的患病率随着时间的推移而下降，主要影响因素是时间(χ2 （3) = 19.9, p 2 (2) = 8.8, p = 0.01）。三分之二的人从未达到精神障碍的诊断标准。研究完成者（n = 592）的敏感性分析显示了与主要分析相似的模式。结论：低社会经济地位的癌症患者对癌症相关压力源的应对能力受损，其精神障碍的风险增加。社会差异可能通过健康行为或健康素养影响身心健康，需要通过量身定制的遗属护理规划加以解决。
Course of Mental Disorders in Early Cancer Survivorship in Relation to Socioeconomic Status: A Multi-Center Prospective Longitudinal Study (LUPE).
Objective: Individuals with low socioeconomic status (SES) exhibit higher rates of mental disorders; however, data in oncological populations are insufficient. This study investigated the course of DSM-5 mental disorders in cancer patients, stratified by SES, over a period of 1.5 years following initial cancer diagnosis.
Methods: This multi-center prospective longitudinal study assessed cancer patients within two months of cancer diagnosis (t1), and at 6-, 12-, and 18-month follow-up (t2-t4) using the SCID-5 interview for mental disorders based on DSM-5 criteria. Chi-square-tests were tested for frequency changes over time. A generalized linear mixed model (GLMM) was applied with fixed effects for SES and time on mental disorders.
Results: Out of 1030 patients with a SCID-5 at baseline (53.2% men, 60 years), 821, 719 and 654 participated at respective follow-ups. The most common diagnoses were skin and prostate cancer. Point prevalence of mental disorders was 20.9% at baseline, decreasing to 18.2%, 14.6%, and 15.0% (t2-t4; χ2 (3) = 15.3, p = 0.002). Patients with low SES consistently showed highest prevalence rates, whereas patients with high SES showed decreasing rates of mental disorders over time, with a main effect of time (χ2 (3) = 19.9, p < 0.001) and SES (χ2 (2) = 8.8, p = 0.01) in the GLMM. Two thirds never met diagnostic criteria for a mental disorder. Sensitivity analysis among study completers (n = 592) revealed a similar pattern to the main analysis.
Conclusions: Cancer patients with low SES exhibit impaired coping with cancer-related stressors, increasing their risk for mental disorders. Social disparities affect physical and mental health, possibly via health behavior or health literacy, and need to be addressed by tailored survivorship care planning.
期刊介绍：
Psycho-Oncology is concerned with the psychological, social, behavioral, and ethical aspects of cancer. This subspeciality addresses the two major psychological dimensions of cancer: the psychological responses of patients to cancer at all stages of the disease, and that of their families and caretakers; and the psychological, behavioral and social factors that may influence the disease process. Psycho-oncology is an area of multi-disciplinary interest and has boundaries with the major specialities in oncology: the clinical disciplines (surgery, medicine, pediatrics, radiotherapy), epidemiology, immunology, endocrinology, biology, pathology, bioethics, palliative care, rehabilitation medicine, clinical trials research and decision making, as well as psychiatry and psychology.
This international journal is published twelve times a year and will consider contributions to research of clinical and theoretical interest. Topics covered are wide-ranging and relate to the psychosocial aspects of cancer and AIDS-related tumors, including: epidemiology, quality of life, palliative and supportive care, psychiatry, psychology, sociology, social work, nursing and educational issues.
Special reviews are offered from time to time. There is a section reviewing recently published books. A society news section is available for the dissemination of information relating to meetings, conferences and other society-related topics. Summary proceedings of important national and international symposia falling within the aims of the journal are presented.
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