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<p><b>BACKGROUND</b>Despite psycho-oncological concerns and studies having thrived these past decades, sparse reports illustrate to what extent Chinese cancer patients are involved and influenced by comorbid mental health problems. To investigate the mental health condition of cancer patient, as well as its possible impacts on prognosis, the first large-scale survey was performed in the west of China.</p><p><b>METHODS</b>For standardizing and facilitating the assessment of mental illness in inpatients with cancer, a multidisciplinary rating flow was designed and established. On the basis of this system, between May 1st and 31st 2009, 2279 cancer inpatients from nine medical centers received preliminarily screening executed by oncologists using screening scales Mental Health Screening Questionnaire (MHSQ), Zung self-rating depression scales (SDS), Zung self-rating anxiety scale (SAS), and posttraumatic stress disorder checklist-civilian version (PCL-C). Further analyses of the ones screened positively were conducted by psychiatrists applying corresponding symptom-rating scales (HAMA/HAMD/BPRS). We summarized the overall proportion of patients with impaired mental health based on the data acquired from preliminary screening, and then calculated occurrence rates of each clinical syndrome of mental disorder according to symptom conclusions. The impact of comorbid mental illness was evaluated through the follow-up scheduled 1 year later, by comparing the survival rate, progression of disease, and quality of life (QoL) between subgroup patients with or without clinical syndrome of mental disorder.</p><p><b>RESULTS</b>In preliminary screenings, 26.1% (595/2279) yielded positive results. Further symptom conclusions confirmed 15.8% (359/2279) with clinical syndrome of mental disorder. Regarding specific type of syndrome, the occurrence rates of depression, anxiety, psychotic symptoms, and stress-related disorders were 13.3%, 10.2%, 2.8%, and 1.4%, respectively. Follow-up assessments were successfully performed in 1918 subjects (84.2%). Further analyses indicated that although insignificant influence was observed in terms of 1-year survival rate and disease progression, cancer patients with a clinical syndrome of mental disorder obtained significantly lower levels (P < 0.05) in five domains of QoL (scored by QLQ-C30).</p><p><b>CONCLUSION</b>In China, at least 26% of cancer patients experienced impaired mental health, of which 60% already had a detectable clinical syndrome of mental disorder, which could significantly undermine their QoL.</p>
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Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , China , Epidemiology , Comorbidity , Follow-Up Studies , Mental Disorders , Epidemiology , Mental Health , Neoplasms , PsychologyABSTRACT
Objective To evaluated the independent effects of different types of smoking exposure along with multiple risk factors for hepatocellular carcinoma (HCC) and determined whether the magnitude of smoking was modified by other risk factors, both in men and women.Methods We conducted a case-control study in Xiamen China. 345 HCC patients and 961 healthy control subjects were personally interviewed for several HCC risk factors. Multivariate logistic regression analysis was performed to estimate the adjusted odds ratio (AOR) and 95% confidence interval (CI) for each potential risk factor. Results Cigars and pipes were not related to HCC among non-cigarette smokers. However, passive smoking exposure was associated with HCC in women:AOR, 2.35 (95%CI: 1.19-4.07). Regular cigarette smoking was associated with HCC in men: AOR,2.27 (95% CI: 1.14-3.31). Cigarette smoking and chronic infection of hepatitis B virus showed positive additive model interactions in men: RERI(relative excess risk due to interaction) was 98.70and AP (attributable proportion due to interactions) was 81.0%. Data on cigarette smoking with high AFB1-albumin adducts in women showed that the RERI was 2.69 and AP was 50.0%. Conclusion We concluded that sex differences were seen in HCC relationship with cigarette smoking. Controlling of exposure to smoking might be a prudent approach to the prevention of HCC, especially in patients with chronic viral hepatitis infections.
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Objective To assess the prevalence,demographic characteristics,risk factors and protective factors on major depression disorder(MDD)among the affected people in the epicenter,7 months after the 2008-earthquake in Wenchuan,China.Methods Stratified multistage cluster randomization was conducted to choose 14 503 subjects aged 15 years or over in the city of Dujiangyan,Beichuan county and Qingchuan county,Sichuan province.We used the general health questionnaire(GHQ-12)as the screening instrument,and the structured clinical interview for DSM-Ⅳ-TR axis Ⅰ disorder-patient edition(SCID-Ⅰ/P)as the tool for diagnosis.Results There were 180 persons diagnosed as MDD with other 13 asymptomatic ones.The point prevalence of MDD was 1.27% and the lifetime prevalence was 1.36%.Risk factors were including:being female(OR=1.56,95%CI:1.136～ 2.143,P＜0.05),co-morbidity with somatic diseases(OR=4.02,95%CI:2.75-5.90,P＜0.05),wounded in the earthquake(OR=3.29,95%CI:1.92-5.65,P＜0.05),property loss up to 10 000-20 000 Yuan(OR=2.09,95%CI:1.18-3.69,P＜0.05),property loss up to＞20 000 Yuan(OR=2.54,95%CI:1.38-4.68,P＜0.05),death or missing of family members(OR=3.79,95%CI:2.08-6.89,P＜0.05)and in middle-age(OR=2.31,95%CI:1.38-3.86,P＜0.05)etc.Having had a job seemed to be a protective factor(OR=0.60,95%CI:0.43-0.83,P＜0.05).Conclusion Major depressive disorder appeared to be a common psychiatric disease in these quake-stricken areas,that causing serious problems.Sustained follow-up and care provided to the affected people in these areas were of extreme importance.
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<p><b>OBJECTIVE</b>To determine whether the serotonin transporter (5-HTT) and norepinephrine transporter (NET) gene polymorphisms were associated with the susceptibility to depression.</p><p><b>METHODS</b>Five hundred and seventy-nine patients with depression, evaluated using a 17-item Hamilton Depression Rating Scale for Depression (HAMD), and 437 healthy controls, all of Chinese Han origin, were genotyped by polymerase chain reaction.</p><p><b>RESULTS</b>Both genotype distributions (P=0.033) and allele frequencies (P=0.023, OR = 1.250, 95% CI = 1.031-1.517) of NET-T182C were significantly different between patients and controls, where the T allele was associated with the onset of depression. Both NET-T182C T- and 5- HTTLPR L-carriers had higher baseline HAMD scores (P=0.032 and 0.023, respectively). There was an interaction between NET-T182C and 5-HTTLPR, where the combined genotype distributions were associated with both onset of depression (P=0.006) and the baseline HAMD scores (P=0.007).</p><p><b>CONCLUSION</b>This study suggested a positive relationship between the NET-T182C polymorphism and the susceptibility to depression, and a positive relationship between NET-T182C/5-HTTLPR polymorphisms and the severity of depression.</p>