Depression, anxiety, and sleep disorders in patients with hepatocellular carcinoma: A nationwide population-based prospective in Taiwan

• Main Authors: I-Chen Tsai, 蔡宜蓁
• Other Authors: Ke-Zong MA
• Format: Others
• Language: zh-TW
• Published: 2012
• Online Access: http://ndltd.ncl.edu.tw/handle/06932345546463166372

碩士 === 高雄醫學大學 === 醫務管理學研究所碩士在職專班 === 100 === Purpose According to the statistics of the Department of Health, malignat tumors are still No.1 on the top ten causes of death and the statistics indicate that liver cancer ranks the first for males and the second for females, which results in a bearing burden on medical resources. It is a common problem for most cancer patients to have sleeping disorders. According to cancer patients reports form new diagnoses show that sleeping disorders accounted for 30 to 50% and insomnia prevalence rate reached up to 67% clinical patients which linked sleeping tablets to account for 44 to 48% of patients. This population-based non-concurrent prospective study aims to estimate the risks of depression, anxiety, and sleep disorders among hepatocellular carcinoma (HCC) patients in Taiwan and to examine whether these symptoms and psychiatric care affect the mortality of HCC patients, after adjusting for the effects of known covariates. Method A total of 3, 361 HCC patients were identified from the 2000 Longitudinal Health Issuance Database (2000 LHID) in the National Health Insurance Research Database (NHIRD) of Taiwan. As well, the same numbers of non-cancer subjects were randomly selected from the same 2000 LHID as the control group. We compared the risks for depression, anxiety, and sleep disorders between HCC patients and controls and examined whether mental disorders and psychiatric care affect mortality of HCC patients using Cox’s regression model with time-dependent covariates. Statistical analysis was performed using the R 2.14.1 software (R Foundation for Statistical Computing, Vienna, Austria). Results Compared to non-cancer controls, HCC patients had higher hazard rates of subsequent anxiety, and sleep disorders (HR=1.2708, 1.2680, respectively, and p < 0.0001). Furthermore, HCC patients with subsequent sleep disorders had poorer outcome in terms of survivorship (HR=1.1790, and p < 0.0001), but receiving care from psychiatrists would reduce the risk of dying for HCC patients with mental disorders (HR=0.7267, and p < 0.0047). Conclusion Close attention should be paid to HCC patients for psychiatric disorders. Proper care by psychiatrists would lead to better prognoses of HCC patients with subsequent mental disorders. A focus needs to be placed on the identification and treatment of subsequent mental disorders through psychiatric intervention, so as to reduce mortality risks for HCC patients. More rigorous investigation of these psychiatric disorders is warranted to improve treatment strategies.