Abstract
BackgroundIn cancer patients, depressive disorder comorbidity is associated with greater suicide risk and poorer treatment outcomes, quality of life, and adherence to treatment. The aim of the study was to evaluate the incidence of newly-diagnosed depressive disorders after a gastric cancer diagnosis compared with a matched cohort using the National Health Insurance Research Database in Taiwan.MethodsWe conducted a retrospective cohort study of 57,506 patients (28,753 patients with gastric cancer and 28,753 matched patients) selected from the National Health Insurance Research Database. Patients were observed for a maximum of 12 years to determine the incidence of newly-diagnosed depressive disorders. Also, a Cox regression analysis which included death as an independent censor was performed to identify the potentially predictive variables for developing subsequent depressive disorders following a cancer diagnosis among the patients suffering from gastric cancer.ResultsThe cumulative incidence of depressive disorders in the gastric cancer patients was significantly higher compared to those in the matched cohort (p < .001). The adjusted hazard ratio was 1.54 (95% confidence interval, CI = 1.39–1.70, P < .001) in the gastric cancer cohort compared with the matched cohort. Independent predictive variables for developing subsequent depressive disorders among the patients with gastric cancer included female sex and hypertension.ConclusionsIn the study, higher incidence of new-onset depression, being defined by the records of the diagnostic codes combining antidepressants use in a nationwide database, was noted in the gastric cancer patients compared with the matched cohort. In addition, female sex and comorbid hypertension may be predictive variables for the subsequent depression among the patients with gastric cancer. Further clinical prospective studies were necessary to confirm these findings.
Highlights
In cancer patients, depressive disorder comorbidity is associated with greater suicide risk and poorer treatment outcomes, quality of life, and adherence to treatment
The National Health Insurance Research Database (NHIRD) is managed by the National Health Research Institutes (NHRI) and confidentiality is maintained according to the directives of the National Health Insurance (NHI) Bureau
The adjusted hazard ratio (HR) was 1.54 (95% confidence interval, Confidence interval (CI) = 1.39–1.70, P < .001) in the gastric cancer cohort compared with the matched cohort
Summary
Depressive disorder comorbidity is associated with greater suicide risk and poorer treatment outcomes, quality of life, and adherence to treatment. The aim of the study was to evaluate the incidence of newly-diagnosed depressive disorders after a gastric cancer diagnosis compared with a matched cohort using the National Health Insurance Research Database in Taiwan. In 2012, an estimated 951,600 newly diagnosed gastric cancer patients and 723,100 deaths occurred worldwide [5]. Gastric cancer rates are generally about twice as. Evidence has revealed that depressive disorders are associated with reduced quality of life and poorer outcomes in patients with cancer [10]. Several studies found an increased risk of suicide among patients with cancer compared with the general population [11,12,13]. Depression has been associated with poor survival among gastric cancer patients in China [14]
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