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Depression Treatment in Individuals with Cancer: A Comparative Analysis with Cardio-Metabolic Conditions

机译:癌症个体的抑郁症治疗:与心脏代谢状况的比较分析

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摘要

A clear picture of the current state of nation-wide depression treatment practices in individuals with cancer and depression does not exist in the United States (US). Therefore, the primary objective of this study was to examine rates of any depression treatment among individuals with cancer and depression in the US. To better understand the relationship between any treatment for depression and presence of cancer, we used a comparison group of individuals with cardio-metabolic conditions owing to the similar challenges faced in management of depression in individuals with these conditions. We used a retrospective cross-sectional design and data from multiple years of the Medical Expenditure Panel Survey, a nationally representative household-survey on healthcare utilization and expenditures. Study sample consisted of adults aged 21 or older with self-reported depression and cancer (n=528) or self-reported depression and diabetes, heart disease or hypertension (n=1643). Depression treatment comprised of any use of antidepressants and/or any use of mental health counseling services. Treatment rates for depression were 78.0% and 81.7% among individuals with cancer and cardio-metabolic conditions respectively. After controlling for socio-demographic, access-to-care, number of physician-visits, health-status, and lifestyle risk-factors related variables; individuals with cancer were less likely to report any treatment for depression (Adjusted Odds Ratio=0.67; 95% Confidence Interval=0.49, 0.92) compared to individuals with cardio-metabolic conditions (P≤0.01). Our findings highlight the possibility that competing demands may crowd out treatment for depression and that cancer diagnosis may be a barrier to depression treatment.
机译:在美国(美国),没有关于癌症和抑郁症患者的全国范围内抑郁症治疗实践现状的清晰图片。因此,这项研究的主要目的是检查美国癌症和抑郁症患者中任何抑郁症治疗的比率。为了更好地了解任何抑郁症治疗方法与癌症存在之间的关系,我们使用了一个患有心脏代谢疾病的个体作为对照组,因为患有这些疾病的个体在抑郁症管理方面面临着相似的挑战。我们使用了多年医疗支出小组调查的回顾性横断面设计和数据,该调查是有关医疗保健利用和支出的全国性家庭调查。研究样本包括21岁或以上患有自我报告的抑郁症和癌症(n = 528)或自我报告的抑郁症和糖尿病,心脏病或高血压(n = 1643)的成年人。抑郁治疗包括使用抗抑郁药和/或使用心理健康咨询服务。在患有癌症和心脏代谢疾病的个体中,抑郁症的治疗率分别为78.0%和81.7%。在控制了社会人口统计资料,就诊机会,就诊人数,健康状况以及生活方式风险因素相关变量之后;与患有心脏代谢疾病的患者相比,患有癌症的患者报告抑郁症的可能性更低(调整后的赔率比= 0.67; 95%置信区间= 0.49,0.92)(P≤0.01)。我们的研究结果突显出竞争需求可能排挤抑郁症治疗的可能性,而癌症诊断可能成为抑郁症治疗的障碍。

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