Cancer and mental disorders in a national community sample: Findings from the National Comorbidity Survey

Objective: To determine the association between cancer ( past 12 months) and mental disorders ( past 12 months) among community-dwelling adults. Methods: Data were drawn from the National Comorbidity Survey (n = 5,877), a representative household sample of adults aged 15 - 54 years in the United States. Multiple logistic regression analyses were used to determine the association between cancer and mental disorders, adjusting for differences in sociodemographic characteristics. Results: Cancer was significantly associated with increased rates of major depression [ odds ratio ( OR) = 3.6, 95% confidence interval (CI) = 1.4 - 8.8], drug dependence ( OR = 3.6, 95% CI = 1.3 - 9.8), simple phobia ( OR = 2.5, 95% CI = 1.0 - 6.2) and agoraphobia ( OR = 3.3, 95% CI = 1.0 - 10.4). These associations persisted after adjusting for major sociodemographic factors, and sex plays a significant role in the association between cancer diagnosis and mental disorder, with cancer diagnosis having a stronger influence on major depression and drug dependence in men than in women. Conclusions: Clinicians and community health workers working with cancer survivors need to be not only alert for signs of clinical depression but also of co-occurring drug dependence and certain anxiety disorders so that appropriate referrals to mental health professionals can be made. Copyright (C) 2004 S. Karger AG, Basel.