DATAPOINTS
Trends in Antidepressant Use Among U.S. Cancer Survivors, 1999–2012 Xiaoling Xiang, M.Phil., Ruopeng An, Ph.D., Sarah Gehlert, Ph.D.
Percentage
One in three patients with cancer experiences FIGURE 1. Prevalence of antidepressant use among U.S. adult cancer survivors and a some type of mental disorder (1). Antidepres- adults without a cancer history, 1999–2012 30 sants are effective in treating depressive sympCancer survivors No cancer history toms among cancer survivors (2). However, 25 little is known about the prevalence and trends of antidepressant use in this group. 20 This study tracked trends in antidepressant use from 1999 to 2012 among cancer survivors 15 age $20 by using data from the National Health and Nutrition Examination Survey. 10 Diagnosis was ascertained on the basis of the question, “Have you ever been told by 5 a doctor or other health professional that you had cancer or a malignancy of any kind?” 0 1999– 2001– 2003– 2005– 2007– 2009– 2011– Cancer survivorship was defined as a cancer 2000 2002 2004 2006 2008 2010 2012 diagnosis (most recent, excluding nonmelaa Source: National Health and Nutrition Examination Survey, 1999–2012 waves. Error bars noma skin cancer) three years or more before denote 95% CIs. the survey. Current use of prescription medications was recorded by interviewers on the benefits of antidepressants and risks of side effects in treating basis of bottles provided by participants, and they were clasdepression among cancer survivors. sified according to Lexicon Plus (www.multum.com/Lexicon. htm). Antidepressants were identified by second-level Multum codes (code 249). To facilitate comparison, sex- and AUTHOR AND ARTICLE INFORMATION age-adjusted rates of antidepressant use were estimated for Ms. Xiang is with the School of Social Work and Dr. An is with the Deadults without a cancer history. partment of Kinesiology and Community Health, University of Illinois at From 1999 to 2012, the average rate of antidepressant use Urbana-Champaign (e-mail: [email protected]). Dr. Gehlert is with the among cancer survivors was 18.3% (95% CI516.09%220.62%), George Warren Brown School of Social Work, Washington University in St. Louis. Amy M. Kilbourne, Ph.D., M.P.H., and Tami L. Mark, Ph.D., are editors compared with 12.3% among adults without a cancer history. of this column. Prevalence of use among survivors increased rapidly and nearly doubled (p5.04), from 10.6% (CI56.3%217.3%) in 1999–2000 The authors report no financial relationships with commercial interests. to 20.8% (CI514.0%229.8%) in 2011–2012 (Figure 1). Over Psychiatric Services 2015; 66:564; doi: 10.1176/appi.ps.201500007 the same period, a smaller increase (7.2 percentage points) was observed among adults without a cancer history. The REFERENCES trend in use showed some nonlinearity. Among survivors, the 1. Mehnert A, Brähler E, Faller H, et al: Four-week prevalence of mental rate temporarily declined, from 21.2% (CI514.8%229.4%) in disorders in patients with cancer across major tumor entities. Journal 2003–2004 to 18.6% (CI514.4%223.7%) in 2005–2006, but of Clinical Oncology 32:3540–3546, 2014 resumed increasing thereafter. 2. Laoutidis ZG, Mathiak K: Antidepressants in the treatment of Antidepressant use among cancer survivors increased depression/depressive symptoms in cancer patients: a systematic review and meta-analysis. BMC Psychiatry 13:140, 2013 notably over the past decade. Future studies should examine
564
ps.psychiatryonline.org
Psychiatric Services 66:6, June 2015
Trends in Antidepressant Use Among U.S. Cancer Survivors, 1999–2012 Xiaoling Xiang, M.Phil., Ruopeng An, Ph.D., Sarah Gehlert, Ph.D.
Percentage
One in three patients with cancer experiences FIGURE 1. Prevalence of antidepressant use among U.S. adult cancer survivors and a some type of mental disorder (1). Antidepres- adults without a cancer history, 1999–2012 30 sants are effective in treating depressive sympCancer survivors No cancer history toms among cancer survivors (2). However, 25 little is known about the prevalence and trends of antidepressant use in this group. 20 This study tracked trends in antidepressant use from 1999 to 2012 among cancer survivors 15 age $20 by using data from the National Health and Nutrition Examination Survey. 10 Diagnosis was ascertained on the basis of the question, “Have you ever been told by 5 a doctor or other health professional that you had cancer or a malignancy of any kind?” 0 1999– 2001– 2003– 2005– 2007– 2009– 2011– Cancer survivorship was defined as a cancer 2000 2002 2004 2006 2008 2010 2012 diagnosis (most recent, excluding nonmelaa Source: National Health and Nutrition Examination Survey, 1999–2012 waves. Error bars noma skin cancer) three years or more before denote 95% CIs. the survey. Current use of prescription medications was recorded by interviewers on the benefits of antidepressants and risks of side effects in treating basis of bottles provided by participants, and they were clasdepression among cancer survivors. sified according to Lexicon Plus (www.multum.com/Lexicon. htm). Antidepressants were identified by second-level Multum codes (code 249). To facilitate comparison, sex- and AUTHOR AND ARTICLE INFORMATION age-adjusted rates of antidepressant use were estimated for Ms. Xiang is with the School of Social Work and Dr. An is with the Deadults without a cancer history. partment of Kinesiology and Community Health, University of Illinois at From 1999 to 2012, the average rate of antidepressant use Urbana-Champaign (e-mail: [email protected]). Dr. Gehlert is with the among cancer survivors was 18.3% (95% CI516.09%220.62%), George Warren Brown School of Social Work, Washington University in St. Louis. Amy M. Kilbourne, Ph.D., M.P.H., and Tami L. Mark, Ph.D., are editors compared with 12.3% among adults without a cancer history. of this column. Prevalence of use among survivors increased rapidly and nearly doubled (p5.04), from 10.6% (CI56.3%217.3%) in 1999–2000 The authors report no financial relationships with commercial interests. to 20.8% (CI514.0%229.8%) in 2011–2012 (Figure 1). Over Psychiatric Services 2015; 66:564; doi: 10.1176/appi.ps.201500007 the same period, a smaller increase (7.2 percentage points) was observed among adults without a cancer history. The REFERENCES trend in use showed some nonlinearity. Among survivors, the 1. Mehnert A, Brähler E, Faller H, et al: Four-week prevalence of mental rate temporarily declined, from 21.2% (CI514.8%229.4%) in disorders in patients with cancer across major tumor entities. Journal 2003–2004 to 18.6% (CI514.4%223.7%) in 2005–2006, but of Clinical Oncology 32:3540–3546, 2014 resumed increasing thereafter. 2. Laoutidis ZG, Mathiak K: Antidepressants in the treatment of Antidepressant use among cancer survivors increased depression/depressive symptoms in cancer patients: a systematic review and meta-analysis. BMC Psychiatry 13:140, 2013 notably over the past decade. Future studies should examine
564
ps.psychiatryonline.org
Psychiatric Services 66:6, June 2015
