Background/objectives:Depression is a common complication of cancer and is associated with distress and reduced participation in medical care. The prevalence is still uncertain in advanced cancer due to methodological problems. Our aim was to study depression in the last year of life and related variables.Methods:We used an administrative database and analyzed clinically verified diagnoses of depression during the last year of life for 27,343 persons (nursing home residents excluded) and related the data to age, sex, socioeconomic status on an area level (Mosaic system), and frailty risk as calculated by the Hospital Frailty Risk Score (HFRS). T-tests, chi-2 tests, and binary logistic regression models were used.Results:During the last year of life, a clinical diagnosis of depression was found in 1168/27,343 (4.3%) cases and more frequently seen in women (4.8% vs. 3.8%,p= 0.001), in the elderly aged 80 years or more,p= 0.03, and especially in persons with a frailty risk according to the HFRS, with rates of 3.3%, 5.3% and 7.8% in the low-risk, intermediate and high-risk groups, respectively (p< 0.001), whereas no differences were found based on socioeconomic status. In a multiple logistic regression model, being female (aOR 1.30, 95% CI 1.16–1.46) or having an intermediate (1.66, 1.46–1.88) or high frailty risk (2.57, 2.10–3.14) retained the predictive value (p< 0.001, respectively).Conclusions:Depression is more common in women and, above all, in people with multimorbidity. Depression affects the amount of health care needed, including the need for psychiatric care. Therefore, it should be included in clinical decision-making, especially as depression is associated with poorer prognosis in cancer.
背景/目的：抑郁症是癌症的常见并发症，与痛苦感加剧及医疗参与度降低相关。由于研究方法学上的问题，其在晚期癌症患者中的患病率仍不明确。本研究旨在探讨生命最后一年中抑郁症的发生情况及其相关变量。 方法：我们利用行政数据库，分析了27,343名（排除养老院居民）个体在生命最后一年内经临床确诊的抑郁症诊断数据，并将这些数据与年龄、性别、地区层面的社会经济地位（采用Mosaic系统评估）以及通过医院衰弱风险评分（HFRS）计算的衰弱风险进行关联分析。研究采用t检验、卡方检验和二元逻辑回归模型。 结果：在生命最后一年中，1168/27,343例（4.3%）被临床诊断为抑郁症。女性（4.8% vs. 3.8%，p=0.001）、80岁及以上老年人（p=0.03）以及根据HFRS评估存在衰弱风险的个体中抑郁症更为常见，其中低风险、中风险和高风险组的患病率分别为3.3%、5.3%和7.8%（p<0.001），而社会经济地位未发现显著差异。多元逻辑回归模型显示，女性（调整后比值比aOR 1.30，95%置信区间1.16–1.46）或具有中度（1.66，1.46–1.88）及高度衰弱风险（2.57，2.10–3.14）仍保持预测价值（p值均<0.001）。 结论：抑郁症在女性中更为常见，尤其在患有多重疾病的个体中尤为突出。抑郁症会影响所需的医疗资源，包括精神科护理需求。因此，在临床决策中应充分考虑抑郁症的影响，特别是考虑到抑郁症与癌症不良预后的关联性。
High Frequency of Depression in Advanced Cancer with Concomitant Comorbidities: A Registry Study
肿瘤(癌症)患者之家