Background/Objectives: With breast cancer (BC) survival improving due to optimized therapy, enhancing quality of life has become increasingly important. Both diagnosis and treatment, with their potential side effects, pose risks to mental well-being. Our study aimed to analyze the incidence and potential risk factors for mental disorders in BC patients. Methods: This retrospective analysis used claims data from AOK Baden-Wuerttemberg, including 11,553 BC patients diagnosed via ICD code C50 between 2010 and 2020 and 31,944 age-matched controls. Patients with mental disorders in the 12 months prior to diagnosis were excluded. Mental disorders were categorized into eight groups based on ICD codes: anxiety, obsessive compulsive disorder, adjustment disorder, dissociative disorder, hypochondriac disorder, affective disorder, mania, and other neuroses. Results: Mental disorders were significantly more common in BC patients than in controls (64.2% vs. 38.1%,p< 0.01, OR 2.91, 95%CI [2.79, 3.04]). In particular, hypochondriac, anxiety, affective, and adjustment disorders occurred significantly more often in BC patients. No differences were found for mania, bipolar disease, other neuroses, obsessive compulsive-, or dissociative disorders. Furthermore, endocrine therapy was associated with psychological comorbidities (OR 1.69,p< 0.001, 95%CI [1.53, 1.86]), while primarily metastasized patients (stage C) had a lower risk than adjuvant patients in stage A (OR 0.55,p< 0.0001, 95%CI [0.49, 0.61]). Regarding surgical treatment, mastectomy patients showed lower rates of mental illnesses (61.2%) than those with breast-conserving treatment (71.6%), or especially breast reconstruction (78.4%,p< 0.01). Breast reconstruction was also associated with more hypochondriac (p< 0.01) and adjustment disorders (p< 0.01). Conclusions: So, BC patients experience significantly more mental disorders than controls, particularly when treated with endocrine therapy and breast reconstructive surgery.
背景/目的：随着优化治疗改善乳腺癌生存率，提升生活质量日益重要。诊断与治疗过程及其潜在副作用均可能对心理健康构成风险。本研究旨在分析乳腺癌患者精神障碍的发生率及潜在风险因素。方法：本回顾性分析使用德国巴登-符腾堡州法定健康保险数据，纳入2010至2020年间经ICD编码C50确诊的11,553例乳腺癌患者及31,944例年龄匹配的对照者。排除诊断前12个月内存在精神障碍病史者。根据ICD编码将精神障碍分为八类：焦虑症、强迫症、适应障碍、分离障碍、疑病症、情感障碍、躁狂症及其他神经症。结果：乳腺癌患者精神障碍发生率显著高于对照组（64.2% vs. 38.1%，p<0.01，OR 2.91，95%CI [2.79, 3.04]）。其中疑病症、焦虑症、情感障碍和适应障碍在乳腺癌患者中发生率尤为显著。躁狂症、双相情感障碍、其他神经症、强迫症及分离障碍的发生率未见组间差异。内分泌治疗与心理共病显著相关（OR 1.69，p<0.001，95%CI [1.53, 1.86]），而原发性转移患者（C期）较A期辅助治疗患者精神障碍风险更低（OR 0.55，p<0.0001，95%CI [0.49, 0.61]）。手术治疗方面，乳房切除术患者精神疾病发生率（61.2%）低于保乳治疗（71.6%）及乳房重建术患者（78.4%，p<0.01），其中乳房重建术与更高比例的疑病症（p<0.01）和适应障碍（p<0.01）相关。结论：乳腺癌患者精神障碍发生率显著高于对照组，接受内分泌治疗及乳房重建手术的患者尤为明显。
肿瘤(癌症)患者之家