乳腺癌后的突发精神障碍：一个匹配的基于人群的队列

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research Pub Date : 2025-03-22 DOI:10.1016/j.jpsychores.2025.112108

Alzina Koric , Chun-Pin Esther Chang , N. Lynn Henry , Mark Dodson , Michael G. Newman , Ankita P. Date , Vikrant G. Deshmukh , Mia Hashibe

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引用次数: 0

摘要

目的评估乳腺癌幸存者的精神障碍风险及抑郁影响因素，并估计其死亡风险。方法在1997年至2017年期间，犹他州癌症登记处共确定了20,440名被诊断患有乳腺癌的女性，并与未患癌症的普通女性人群相匹配。为了评估乳腺癌后精神障碍和死亡的风险，总体上使用Cox比例风险模型估计了风险比（hr）和99%置信区间（CI），范围在2，>；2到5，和>；5年随访。结果与未患癌症的女性相比，乳腺癌幸存者在随访2年内抑郁（HR 2.64, 99% CI 2.43, 2.87）、焦虑（HR 2.89, 99% CI 2.66, 3.15）、双相情感障碍（HR 1.85, 99% CI 1.45, 2.37）、酒精（HR 1.88, 99% CI 1.43, 2.46）和物质相关障碍（HR 1.95, 99% CI 1.59, 2.39）的抑郁风险明显升高。虽然与即时随访相比，风险有所降低，但癌症后5年内酒精和物质障碍的负担持续存在，抑郁和焦虑持续5年。在癌症发生后2年内被诊断患有物质相关疾病的乳腺癌幸存者的死亡风险比同期未被诊断患有物质相关疾病的乳腺癌幸存者高2.3倍（HR 2.28, 99% CI 1.72, 3.03）。抑郁预测因素包括肥胖、≥2种合并症、化疗或分离。结论与未患癌症的女性相比，乳腺癌幸存者患多种精神障碍的风险较高。患有药物相关疾病的乳腺癌幸存者的死亡风险明显增加。

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Incident mental disorders after breast cancer: A matched population-based cohort

Objective

To assess the risk of mental disorders and contributing factors of depression in breast cancer survivors, as well as to estimate the risk of death.

Methods

A total of 20,440 women diagnosed with breast cancer between 1997 and 2017 were identified in the Utah Cancer Registry and matched to a general population of women without cancer. To assess the risk of mental disorders and death following breast cancer, hazard ratios (HRs) and 99 % confidence intervals (CI) were estimated using Cox proportional-hazards models overall, within 2, > 2 to 5, and > 5-years of follow-up.

Results

Compared with women without cancer, breast cancer survivors had an elevated risk of depression notably within 2 years of follow-up for depression (HR 2.64, 99 %CI 2.43, 2.87), anxiety (HR 2.89, 99 %CI 2.66, 3.15), bipolar (HR 1.85, 99 %CI 1.45, 2.37), alcohol (HR 1.88, 99 %CI 1.43, 2.46), and substance-related disorders (HR 1.95, 99 %CI 1.59, 2.39). Although the risks were attenuated compared to the immediate follow-up, the burden of alcohol- and substance-disorders persisted within 5 and depression and anxiety >5 years post cancer. Breast cancer survivors diagnosed with substance-related disorders within 2 years of cancer had a 2.3-fold higher risk of death (HR 2.28, 99 % CI 1.72, 3.03) compared to those without during the same time period. Depression predictors included obesity, ≥2 comorbidities, chemotherapy, or being separated.

Conclusion

Compared with women without cancer, breast cancer survivors had an elevated risk of multiple mental disorders. The risk of death was notably increased among breast cancer survivors with substance-related disorders.

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来源期刊

Journal of Psychosomatic Research 医学-精神病学

CiteScore

7.40

自引率

6.40%

发文量

314

审稿时长

6.2 weeks

期刊介绍： The Journal of Psychosomatic Research is a multidisciplinary research journal covering all aspects of the relationships between psychology and medicine. The scope is broad and ranges from basic human biological and psychological research to evaluations of treatment and services. Papers will normally be concerned with illness or patients rather than studies of healthy populations. Studies concerning special populations, such as the elderly and children and adolescents, are welcome. In addition to peer-reviewed original papers, the journal publishes editorials, reviews, and other papers related to the journal''s aims.