Risk factors for comorbid anxiety and depression and for a single emotional disorder in patients with lung cancer receiving chemoradiotherapy

doi:10.3969/j.issn.1004-583X.2026.08.011

Abstract

Abstract:

Objective To analyze the risk factors for comorbid anxiety and depression and for a single emotional disorder in patients with lung cancer receiving chemoradiotherapy.Methods A total of 108 patients with lung cancer who underwent chemoradiotherapy at Luohe Central Hospital from September 2022 to September 2025 were enrolled. Sociodemographic data, clinical characteristics, treatment-related factors, and psychological and social factors were collected. Anxiety and depression were assessed 2 weeks after chemoradiotherapy. Patients with both anxiety and depression symptoms were assigned to the comorbidity group (n=42), those with only one emotional symptom were assigned to the single-symptom group (n=40), and the remaining patients were assigned to the asymptomatic group (n=26). Multinomial logistic regression was used to identify independent risk factors for emotional disorders.Results There were 42 patients with comorbid anxiety and depression, 40 patients with either anxiety or depression alone, and 26 asymptomatic patients. Significant differences were observed among the three groups in educational level, personal monthly income, clinical stage, perceived social support scale (PSSS) score, adverse reaction grade, and Pittsburgh sleep quality index (PSQI) score (P<0.05). Logistic regression analysis showed that personal monthly income <3 000 yuan, clinical stage Ⅲ-Ⅳ, PSSS score <40, and PSQI score >7 were independent risk factors for single emotional disorder in patients with lung cancer receiving chemoradiotherapy (P<0.05). Personal monthly income <3 000 yuan, clinical stage Ⅲ-Ⅳ, PSSS score <40, adverse reaction grade 3-4, and PSQI score >7 were independent risk factors for comorbid anxiety and depression (P<0.05). Conclusion Lower personal monthly income, advanced clinical stage, low social support, more severe adverse reactions, and sleep disturbance are risk factors for comorbid anxiety and depression in patients with lung cancer receiving chemoradiotherapy. Early identification of high-risk patients and comprehensive interventions are needed to improve both physical and mental health.

Key words: lung neoplasms, chemoradiotherapy, anxiety, depression, risk factors

CLC Number:

R734.2

Chen Huimin, Ding Ruijuan, Liu He. Risk factors for comorbid anxiety and depression and for a single emotional disorder in patients with lung cancer receiving chemoradiotherapy[J]. Clinical Focus, 2026, 41(8): 736-741.

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URL: https://www.lchc.cn/EN/10.3969/j.issn.1004-583X.2026.08.011

https://www.lchc.cn/EN/Y2026/V41/I8/736

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References 20

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临床资料	共病组(n=42)	单一症状组(n=40)	无症状组(n=26)	χ²值	P值
性别
男女	19(45.24) 23(54.76)	18(45.00) 22(55.00)	10(38.46) 16(61.54)	0.357	0.837
年龄(岁)
≥60 <60	12(28.57) 30(71.43)	16(40.00) 24(60.00)	12(46.15) 14(53.85)	2.368	0.306
文化程度
初中及以下高中及以上	25(59.52) 17(40.48)	14(35.00) 26(65.00)	9(34.62) 17(65.38)	6.330	0.042
吸烟史
有无	21(50.00) 21(50.00)	19(47.50) 21(52.50)	14(53.85) 12(46.15)	0.254	0.881
肿瘤家族史
有无	10(23.81) 32(76.19)	8(20.00) 32(80.00)	3(11.54) 23(88.46)	1.556	0.459
个人月收入
<3 000元 ≥3 000元	31(73.81) 11(26.19)	22(55.00) 18(45.00)	8(30.77) 18(69.23)	12.159	0.002
婚姻状况
已婚未婚/离异/丧偶	26(61.90) 16(38.10)	25(62.50) 15(37.50)	19(73.08) 7(26.92)	1.028	0.598
临床分期
Ⅰ~Ⅱ期 Ⅲ~Ⅳ期	17(40.48) 25(59.52)	22(55.00) 18(45.00)	19(73.08) 7(26.92)	6.908	0.032
病理类型
腺癌	14(33.33)	12(30.00)	9(34.62)
鳞癌	18(42.86)	20(50.00)	12(46.15)	0.556	0.968
小细胞肺癌	10(23.81)	8(20.00)	5(19.23)
放化疗方案
同步放化疗序贯放化疗	29(69.05) 13(30.95)	24(60.00) 16(40.00)	15(57.69) 11(42.31)	1.127	0.569
治疗周期
<3周期 ≥3周期	16(38.10) 26(61.90)	17(42.50) 23(57.50)	12(46.15) 14(53.85)	0.447	0.800
PSSS评分
<40分 ≥40分	31(73.81) 11(26.19)	20(50.00) 20(50.00)	9(34.62) 17(65.38)	10.785	0.005
不良反应分级
0~2级 3~4级	12(28.57) 30(71.43)	23(57.50) 17(42.50)	14(53.85) 12(42.86)	7.910	0.019
PSQI评分
>7分 ≤7分	27(64.29) 15(35.71)	16(40.00) 24(60.00)	10(38.46) 16(61.54)	6.378	0.041

临床资料	共病组(n=42)	单一症状组(n=40)	无症状组(n=26)	χ²值	P值
性别
男女	19(45.24) 23(54.76)	18(45.00) 22(55.00)	10(38.46) 16(61.54)	0.357	0.837
年龄(岁)
≥60 <60	12(28.57) 30(71.43)	16(40.00) 24(60.00)	12(46.15) 14(53.85)	2.368	0.306
文化程度
初中及以下高中及以上	25(59.52) 17(40.48)	14(35.00) 26(65.00)	9(34.62) 17(65.38)	6.330	0.042
吸烟史
有无	21(50.00) 21(50.00)	19(47.50) 21(52.50)	14(53.85) 12(46.15)	0.254	0.881
肿瘤家族史
有无	10(23.81) 32(76.19)	8(20.00) 32(80.00)	3(11.54) 23(88.46)	1.556	0.459
个人月收入
<3 000元 ≥3 000元	31(73.81) 11(26.19)	22(55.00) 18(45.00)	8(30.77) 18(69.23)	12.159	0.002
婚姻状况
已婚未婚/离异/丧偶	26(61.90) 16(38.10)	25(62.50) 15(37.50)	19(73.08) 7(26.92)	1.028	0.598
临床分期
Ⅰ~Ⅱ期 Ⅲ~Ⅳ期	17(40.48) 25(59.52)	22(55.00) 18(45.00)	19(73.08) 7(26.92)	6.908	0.032
病理类型
腺癌	14(33.33)	12(30.00)	9(34.62)
鳞癌	18(42.86)	20(50.00)	12(46.15)	0.556	0.968
小细胞肺癌	10(23.81)	8(20.00)	5(19.23)
放化疗方案
同步放化疗序贯放化疗	29(69.05) 13(30.95)	24(60.00) 16(40.00)	15(57.69) 11(42.31)	1.127	0.569
治疗周期
<3周期 ≥3周期	16(38.10) 26(61.90)	17(42.50) 23(57.50)	12(46.15) 14(53.85)	0.447	0.800
PSSS评分
<40分 ≥40分	31(73.81) 11(26.19)	20(50.00) 20(50.00)	9(34.62) 17(65.38)	10.785	0.005
不良反应分级
0~2级 3~4级	12(28.57) 30(71.43)	23(57.50) 17(42.50)	14(53.85) 12(42.86)	7.910	0.019
PSQI评分
>7分 ≤7分	27(64.29) 15(35.71)	16(40.00) 24(60.00)	10(38.46) 16(61.54)	6.378	0.041

自变量		赋值
文化程度	初中及以下	是	1
		否	0
个人月收入	<3 000元	是	1
		否	0
临床分期	Ⅲ~Ⅳ期	是	1
		否	0
PSSS评分	<40分	是	1
		否	0
不良反应分级	3~4级	是	1
		否	0
PSQI评分	>7分	是	1
		否	0

自变量		赋值
文化程度	初中及以下	是	1
		否	0
个人月收入	<3 000元	是	1
		否	0
临床分期	Ⅲ~Ⅳ期	是	1
		否	0
PSSS评分	<40分	是	1
		否	0
不良反应分级	3~4级	是	1
		否	0
PSQI评分	>7分	是	1
		否	0

因素	单一症状组(vs无症状组)
因素	回归系数	标准误	Wald χ²值	OR值	95%可信区间	P值
文化程度	0.412	0.387	1.132	1.510	0.708~3.221	0.287
个人月收入<3 000元	0.627	0.302	4.309	1.872	1.032~3.395	0.038
临床分期Ⅲ~Ⅳ期	0.840	0.381	4.867	2.316	1.097~4.892	0.027
PSSS评分<40分	0.744	0.353	4.441	2.104	1.052~4.208	0.035
不良反应分级3~4级	0.567	0.342	2.750	1.763	0.902~3.447	0.097
PSQI评分>7分	0.721	0.336	4.603	2.056	1.064~3.974	0.032
因素	共病组(vs无症状组)
因素	回归系数	标准误	Wald χ²值	OR值	95%可信区间	P值
文化程度	0.745	0.413	3.254	2.106	0.938~4.733	0.072
个人月收入<3 000元	0.801	0.328	5.964	2.228	1.171~4.237	0.015
临床分期Ⅲ~Ⅳ期	1.862	0.519	12.871	6.437	2.327~17.801	<0.001
PSSS评分<40分	1.354	0.498	7.392	3.873	1.459~10.279	0.007
不良反应分级3~4级	2.108	0.657	10.295	8.232	2.271~29.836	0.001
PSQI评分>7分	1.726	0.534	10.447	5.618	1.973~16.001	0.001