DATAPOINTS

Trends in Antidepressant Use Among U.S. Cancer

Survivors, 19992012
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, 19992012
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 dened as a cancer
2000
2002
2004
2006
2008
2010
2012
diagnosis (most recent, excluding nonmelaa
Source: National Health and Nutrition Examination Survey, 19992012 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
benets of antidepressants and risks of side effects in treating
basis of bottles provided by participants, and they were clasdepression among cancer survivors.
sied according to Lexicon Plus (www.multum.com/Lexicon.
htm). Antidepressants were identied 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: xxiang3@illinois.edu). 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 19992000
The authors report no nancial relationships with commercial interests.
to 20.8% (CI514.0%229.8%) in 20112012 (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, Brhler 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
20032004 to 18.6% (CI514.4%223.7%) in 20052006, but
of Clinical Oncology 32:35403546, 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

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Psychiatric Services 66:6, June 2015