Cancer and Mental Disorders in a National Community Sample: Findings from the National Comorbidity Survey

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Abstract
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.