英国伦敦大学学院健康信息学研究所Alvina G. Lai研究组分析了26种成人癌症的精神疾病和自残的累积负担。相关论文于2022年3月28日发表于国际顶尖学术期刊《自然—医学》杂志上。

他们评估了 459542 名癌症患者在突发精神疾病诊断后发生自残的风险以及自残后非自然死亡的风险。抑郁症是癌症患者最常见的精神疾病。接受化疗、放疗和手术的患者的精神疾病累积负担最高。接受烷化剂化疗的患者精神疾病负担最高，而接受激酶抑制剂治疗的患者负担最低。所有精神疾病都与随后的自残风险增加有关，其中最高风险在精神疾病诊断后的 12 个月内观察到。在自残的 12 个月内，自残患者死于非自然死亡原因的可能性是对照组的 6.8 倍（风险比 (HR)，6.8；95% 置信区间 (CI)，4.3-10.7）。12 个月后非自然死亡的风险显著降低（HR，2.0；95% CI，1.5-2.7）。

他们提供广泛的知识库，通过优先考虑风险最大的患者，为协作性癌症-精神科护理计划提供信息。

研究人员表示，癌症是一种改变生活的事件，会造成相当大的心理困扰。然而，关于所有常见成人癌症和接受治疗精神疾病总负担的信息仍然很少。

附：英文原文

Title: Cumulative burden of psychiatric disorders and self-harm across 26 adult cancers

Author: Chang, Wai Hoong, Lai, Alvina G.

Issue&Volume: 2022-03-28

Abstract: Cancer is a life-altering event causing considerable psychological distress. However, information on the total burden of psychiatric disorders across all common adult cancers and therapy exposures has remained scarce. Here, we estimated the risk of self-harm after incident psychiatric disorder diagnosis in patients with cancer and the risk of unnatural deaths after self-harm in 459,542 individuals. Depression was the most common psychiatric disorder in patients with cancer. Patients who received chemotherapy, radiotherapy and surgery had the highest cumulative burden of psychiatric disorders. Patients treated with alkylating agent chemotherapeutics had the highest burden of psychiatric disorders, whereas those treated with kinase inhibitors had the lowest burden. All mental illnesses were associated with an increased risk of subsequent self-harm, where the highest risk was observed within 12 months of the mental illness diagnosis. Patients who harmed themselves were 6.8 times more likely to die of unnatural causes of death compared with controls within 12 months of self-harm (hazard ratio (HR), 6.8; 95% confidence interval (CI), 4.3–10.7). The risk of unnatural death after 12 months was markedly lower (HR, 2.0; 95% CI, 1.5–2.7). We provide an extensive knowledge base to help inform collaborative cancer-psychiatric care initiatives by prioritizing patients who are most at risk.

DOI: 10.1038/s41591-022-01740-3

Source: https://www.nature.com/articles/s41591-022-01740-3