文章介紹
癌症確診與治療過程對患者情緒與生活品質影響甚大，過程中的壓力、挫折與不適應感伴隨著憂鬱（depression）風險的增加。探討癌症以及憂鬱的研究顯示減少憂鬱症狀相關於較佳的存活狀況、主要的憂鬱症狀能作為非小細胞肺癌預後的預測因子。
柳醫師團隊以健康大數據進行分析。以攝護腺癌為研究對象，並依臨床治療分成三組：局部或局部侵犯的攝護腺癌、已有轉移的攝護腺癌、對荷爾蒙療法產生抗性的攝護腺癌（castration-resistant prostate cancer）。
統計結果顯示在已有轉移的攝護腺癌這一組別，憂鬱個案顯著有較高的死亡風險（adjusted hazard ratio
= 1.49）
UroToday 網站介紹
UroToday 網站成立於 2003 年，UroToday 網站的宗旨是提供免準確、即時、有證據的泌尿科學和腫瘤學內容，讓醫事人員及時了解疾病和病情，並且協助臨床醫師和患者提高對疾病的理解。並希望能夠從世界各地以實證醫學的角度，來推動泌尿科學與醫學的進步。
榮獲邀稿
很榮幸獲得 UroToday CEO，Gina B. Carithers的來信邀稿，邀請柳醫師研究團隊對於最新發表的憂鬱症與攝護腺癌預後的科學研究，做一個精華濃縮的短評。而這個評論會在 UroToday 的網站上作發表。
於是從研究論文的方法學，以及全文的研究概念做了徹底回顧，再進一步統整出一個完整的評論。希望能讓閱讀到的讀者，能夠更了解到我們這次的研究，想要表達的重要概念就是：已有轉移的攝護腺癌的病患中，若有憂鬱個案顯著有較高的死亡風險。癌症治療與精神支持，這兩者應該都要重視，這樣可以讓我們的患者能接受到更全方位的治療。
精華評論內容
Prostate
cancer is the most common male urologic malignancy around the world. In Taiwan,
it was also growing the number of patients with prostate cancer in recent
years. Androgen deprivation therapy ( ADT ) has been a mainstay treatment for
advanced prostate cancer for decades. However, ADT has several adverse effects
such as metabolic, bone, cardiovascular and erectile function. ADT is also
associated with negative mood status or depression.
In
this retrospective study of 1101 newly diagnosed cases with prostate cancer
utilizing the Taiwan National Health Insurance Research Database. 267 /1101
(24.3%) developed depression with mean follow-up period was 8.30±3.12 years.
Patients with depression were associated with an increased risk of mortality
(aHR: 1.37; 95% CI: 1.04–1.80). Furthermore, patients in the metastatic
prostate cancer group with depression had a significantly higher mortality risk
compared to the non-depression group (aHR: 1.49; 95% CI: 1.05–2.11).
This
result demonstrated that metastatic prostate cancer patients with depression
may have a 49% higher risk of mortality compared to patients in the same
disease stage without depression. Physicians should pay attention to the mood
and psychiatric illness adverse effect in patients with metastatic prostate
cancer. We suggested that treating psychiatric disorder and cancer are both
important in patients with prostate cancer.
特別致謝
