title: Risk of Developing Depressive Disorders following Hepatocellular Carcinoma: A Nationwide Population-Based Study.
abstract: OBJECTIVE
  To evaluate the risk of depressive disorders among patients with Hepatocellular Carcinoma (HCC) using the National Health Insurance Research Database (NHIRD) in Taiwan.
  
  
  METHODS
  We conducted a retrospective study of a newly diagnosed HCC cohort of 55,973 participants who were selected from the NHIRD. Patients were observed for a maximum of 6 years to determine the rates of newly onset depressive disorders, and Cox regression was used to identify the risk factors associated with depressive disorders in HCC patients.
  
  
  RESULTS
  Of the total 55,973 HCC patients, 1,041 patients (1.86%) were diagnosed with depressive disorders during a mean (SD) follow-up period of 1.1 (1.2) years. The Cox multivariate proportional hazards analysis showed that age of 40-59 (HR 1.376, 95% CI 1.049-1.805, p = 0.021), age of 60-79 (HR 1.341, 95% CI 1.025-1.753, p = 0.032), women (HR 1.474 95% CI 1.301-1.669, p < 0.001), metastasis (HR 1.916, 95% CI 1.243-2.953, p = 0.003), and HCV (HR 1.445, 95% CI 1.231-1.697, p < 0.001) were independent risk factors for developing depressive disorders.
  
  
  CONCLUSIONS
  Our study indicated a subsequent risk of depressive disorders in patients with HCC, and the risk increased for those with female gender, aged 40 to 59, aged 60 to 79, with metastasis, or with HCV. Psychological evaluation and support are two critical issues in these HCC patients with the risk factors.
authors: Department of Psychiatry, China Medical University Hospital, Taichung, Taiwan; Institute of Clinical Medicine, China Medical University, Taichung, Taiwan.
authors: Chun-Hung
authors: CH
authors: Chang
authors: Department of Psychiatry, Mackay Memorial Hospital Taitung Branch, Taitung, Taiwan; Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan; Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan.
authors: Shaw-Ji
authors: SJ
authors: Chen
authors: Institute of Nursing-Midwifery, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
authors: Chieh-Yu
authors: CY
authors: Liu
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000523:psychology; D003866:Depressive Disorder / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000523:psychology; D005260:Female; D006526:Hepatitis C / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000523:psychology; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000523:psychology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011581:Psychological Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012944:Social Support; D013624:Taiwan