title: Anxiety and depressive disorders among patients with esophageal cancer in Taiwan: a nationwide population-based study.
abstract: BACKGROUND
  The comorbidity of depression with anxiety disorders is associated with poorer treatment outcomes, worse quality of life, poorer adherence to treatment, and greater suicide risk in cancer patients.
  
  
  OBJECTIVE
  To assess the risk of comorbid anxiety and depressive disorders after the diagnosis of esophageal cancer compared with a matched cohort by using the Taiwan National Health Insurance Research Database (NHIRD).
  
  
  METHODS
  We conducted a retrospective study of 28,454 patients (14,227 patients with esophageal cancer and 14,227 matched patients) who were selected from the NHIRD. Patients were observed for a maximum of 12 years to determine the incidence of new-onset anxiety and depressive disorders for which antidepressants had been prescribed. A Cox regression analysis was performed to identify the risk factors associated with anxiety and depressive disorders in esophageal cancer patients.
  
  
  RESULTS
  The cumulative incidence of anxiety and depressive disorders in the esophageal cancer patients was significantly higher than that in the matched cohort (P < .001). The adjusted hazard ratio (HR) was 2.24 (95 % confidence interval, CI = 1.95-2.56, P < .001) in the esophageal cancer cohort compared with the matched cohort. Independent risk factors for developing anxiety and depressive disorders among the patients with esophageal cancer included cirrhosis, cerebrovascular disease, and surgical treatment.
  
  
  CONCLUSIONS
  Esophageal cancer may be a prominent risk factor for anxiety and depressive disorders. Based on our data, we suggest that attention should be focused on esophageal cancer patients with comorbid cirrhosis and cerebrovascular disease and those who have received surgical interventions.
authors.affiliation: Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors.forename: Li-Yu
authors.initials: LY
authors.lastname: Hu
authors.forename: Fan-Chen
authors.initials: FC
authors.lastname: Ku
authors.forename: Yen-Po
authors.initials: YP
authors.lastname: Wang
authors.forename: Cheng-Che
authors.initials: CC
authors.lastname: Shen
authors.forename: Yu-Wen
authors.initials: YW
authors.lastname: Hu
authors.forename: Chiu-Mei
authors.initials: CM
authors.lastname: Yeh
authors.forename: Pan-Ming
authors.initials: PM
authors.lastname: Chen
authors.forename: Huey-Ling
authors.initials: HL
authors.lastname: Chiang
authors.forename: Ti
authors.initials: T
authors.lastname: Lu
authors.forename: Tzeng-Ji
authors.initials: TJ
authors.lastname: Chen
authors.forename: Chung-Jen
authors.initials: CJ
authors.lastname: Teng
authors.forename: Chia-Jen
authors.initials: CJ
authors.lastname: Liu
mesh_terms: D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000453:epidemiology*; D016022:Case-Control Studies; D015897:Comorbidity; D003866:Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology*; D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
chemical_list: D000928:Antidepressive Agents