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Abstract：
Background: Colorectal cancer (CRC) stands as one of the most prevalent and burdensome malignancies worldwide. Similar to other cancers, CRC has been associated with the development of psychiatric diseases, including anxiety and depression. However, temporal trends in psychiatric disorders rates within CRC patients have not been investigated so far. Methods: The present study included 15,619 individuals with colorectal cancer and 78,095 propensity score-matched individuals without cancer, who were identified within the Disease Analyzer (IQVIA) database in Germany between 2005 and 2022. Cox regression analysis was conducted to assess the association between CHC and subsequent psychiatric diseases, including depression, anxiety disorders, and adjustment disorder, by period (2005-2010, 2011-2016, 2017-2022). Results: The 12-month cumulative incidence of any psychiatric disorder diagnosis in the CRC cohort increased from 6.3% in 2005-2010 to 8.2% in 2017-2022. The strongest increase was observed for reaction to severe stress and adjustment disorder (1.0% in 2005-2010 to 2.6% in 2017-2022). Notably, the strong increase in psychiatric disorders was not specific for cancer patients since a slight increase in psychiatric disorders was also observed in the non-cancer cohort. Regression analyses revealed that CRC was strongly and significantly associated with an increased risk of depression, anxiety disorders, reaction to severe stress and adjustment disorders, as well as any psychiatric disorder. Of note, the extent of the association was stronger in 2017-2022 compared to 2005-2010, clearly proving a \"real\" increase in the rates of psychiatric disorders over time. Conclusions: This study presents novel data from a large cohort of outpatients in Germany, providing strong evidence for an increase in psychiatric disorders in the recent years. These findings contribute to the existing body of literature and should trigger the recognition of psychiatric problems in cancer survivors.
摘要：
背景：结直肠癌（CRC）是全球最普遍和最繁重的恶性肿瘤之一。与其他癌症相似，CRC与精神疾病的发展有关，包括焦虑和抑郁.然而,迄今为止,尚未研究CRC患者中精神疾病发病率的时间趋势.方法：本研究包括15,619例大肠癌患者和78,095例倾向评分匹配的无癌个体，2005年至2022年期间，在德国的疾病分析仪（IQVIA）数据库中确定了这些人。进行Cox回归分析以评估CHC与随后的精神疾病之间的关联。包括抑郁症,焦虑症,和调整障碍，按期间划分（2005-2010年、2011-2016年、2017-2022年）。结果：CRC队列中任何精神疾病诊断的12个月累积发病率从2005-2010年的6.3%增加到2017-2022年的8.2%。观察到对严重压力和适应障碍的反应最强劲的增长（2005-2010年为1.0％，2017-2022年为2.6％）。值得注意的是,精神疾病的显著增加并不是癌症患者特有的,因为在非癌症队列中也观察到精神疾病的轻微增加.回归分析显示，CRC与抑郁症风险增加密切相关。焦虑症,对严重压力和适应障碍的反应，以及任何精神疾病。值得注意的是，与2005-2010年相比,2017-2022年的关联程度更强,这清楚地表明,随着时间的推移,精神疾病的发病率出现了"真实"的增长.结论：这项研究提供了来自德国大量门诊患者的新数据，为近年来精神疾病的增加提供了强有力的证据。这些发现有助于现有的文献，并应引发对癌症幸存者精神问题的认识。
