Watch out for new mental disorders in spouses of cancer patients

Increased stress from a spouse battling cancer may be associated with new clinical diagnoses of psychiatric disorders, a population-based cohort study has found.

A study of more than 3 million people living in Denmark and Sweden found that spouses of cancer patients had a higher incidence of first-onset psychiatric disorders compared with spouses of patients without cancer (6.9% vs. 5.6%), reports Qianwei Liu. Her MD, PhD, and colleagues at her Karolinska Institutet in Stockholm.

This difference translated into a 14% higher risk (adjusted HR 1.14, 95% CI 1.13-1.16) during median follow-up of 8 years or more, the risk of developing depression, substance abuse disorders, and stress-related disorders. has risen as well. (aHR of 1.16-1.25), the group wrote JAMA network open.

A particularly high risk among spouses was seen in the first year after cancer diagnosis (aHR 1.30, 95% CI 1.25-1.34), mainly due to higher incidence of stress-related disorders and depression was.

  • Stress-related disorders: aHR 2.04 (95% CI 1.88-2.22)
  • Depression: aHR 1.38 (95% CI 1.30-1.47)

“The greatest risk increase in the first year after cancer diagnosis was that the risk of adverse health outcomes, including psychiatric disorders, cardiovascular disease, and suicide, was highest in the first year after diagnosis in cancer patients. This was consistent with our previous finding that “it was very difficult to find ourselves,” the researchers noted.

Not surprisingly, spouses were at increased risk of developing psychiatric disorders if they had cancers with a poor prognosis, such as those of the esophagus, lung, or pancreas. For example, a spouse of a pancreatic cancer patient had a 41% increased risk of mental illness. Also, the spouse of someone diagnosed with advanced-stage cancer had a 31% increased risk of psychiatric disorders compared to her.

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Similarly, if a spouse with cancer died during follow-up, the surviving spouse’s risk of mental illness increased by 29%. This was even more pronounced among postmortem male spouses of cancer patients (aHR 1.48, 95% CI 1.44-1.52).

Spouses with pre-existing psychiatric illness had a significantly higher risk of hospital admission for either a recurrence of the condition or another primary psychiatric illness (aHR 1.23, 95% CI 1.20-1.25).

“These results support the need for clinical awareness to prevent potential psychiatric disorders in spouses of cancer patients, especially in these high-risk groups,” said Liu’s group. .

Findings are based on data representing 546,321 spouses of cancer patients compared to over 2.7 million unexposed spouses without pre-existing mental illness. The median age of the cohort was her 60 years. There were slightly more female than male spouses (54% vs. 46%).

Over a median follow-up of 8.4 years, spouses of cancer patients were at greater risk of new diagnoses of depression, substance abuse, stress-related disorders, and anxiety compared with spouses of patients without cancer were respectively high.

  • Depression: 2.9 vs 2.5 cases per 1000 person-years (aHR 1.16, 95% CI 1.14-1.18)
  • Substance abuse: 2.3 vs 1.9 cases per 1000 person-years (aHR 1.20, 95% CI 1.17-1.22)
  • Stress-related disorders: 1.1 vs 0.9 cases per 1000 person-years (aHR 1.25, 95% CI 1.22-1.29)
  • Anxiety: 1.0 vs. 0.9 cases per 1,000 person-years (aHR 1.07, 95% CI 1.04-1.10)

The risk of new-onset diagnoses was highest in the first year, but remained similarly elevated during subsequent follow-up periods (aHR 1.13, 95% CI 1.12-1.14), the researchers noted. .

Psychiatric diagnoses included disorders requiring inpatient or outpatient treatment according to ICD codes. Interestingly, the risks of inpatient and outpatient diagnoses of psychiatric disorders were slightly higher (aHR 1.17 and aHR 1.13, respectively).

  • Kristen Monaco is a staff writer focusing on endocrinology, psychiatry and nephrology news. She is based out of our New York City office and has been with the company since 2015.

Disclosure

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This work was supported by the Swedish Cancer Society, the Karolinska Institutet, the Swedish Research Council on Health, Work Life and Well-Being, the Chinese Scholarship Council, the Novo Nordisk Foundation, the Danish Independent Research Fund, the Nordic Cancer Union, and Karen Elise. I was. Jensen Fond.

Liu and co-authors have relationships with Forte, the Heart and Lung Foundation, the Karolinska Institutet, the Chinese Scholarship Council, the European Research Council, NordForsk, the Swedish Cancer Society, and the Swedish Research Council for Health, Work Life and Well-Being. reported.

Primary information

JAMA network open

See source: Hu K, et al. Risk of mental disorders among spouses of cancer patients in Denmark and Sweden. JAMA Netw Open 2023; DOI: 10.1001/jamanetworkopen.2022.49560.

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