- Researchers say the spouses of people diagnosed with cancer face risks of developing psychiatric disorders.
- They say the risks are highest during the first year after diagnosis.
- Experts say the medical community needs to take these findings into consideration and change treatment from patient-focused to family-focused.
A cancer diagnosis is a difficult and often frightening experience. And not just for the person with the disease.
It can also be trying for a spouse.
The research, published today by JAMA Open Network, reports that husbands and wives of people with cancer often experience an increased risk of several psychiatric disorders that required hospital-based specialist care.
In this cohort study, nearly 7% of spouses of people with cancer developed a psychiatric disorder during follow-up periods, compared with about 5% of spouses of individuals without cancer.
“Cancer diagnosis is not only a diagnosis for the patient but also for their families,” Dr. Kejia Hu, a postdoctoral researcher at the Karolinska Institutet in Stockholm, told Healthline. “Our research group has long been interested in studying the psychiatric consequences of cancer patients and their families, including their parents.”
Dr. Qianwei Liu, a researcher at the Karolinska Institutet, is the corresponding author of the study.
He and his colleagues wrote, “The objective of this study was to assess the overall burden of psychiatric disorders among spouses of patients with cancer vs. spouses of individuals without cancer and to describe possible changes in this burden over time.”
The study included spouses of people with cancer diagnosed from 1986 to 2016 in Denmark and 1973 to 2014 in Sweden as well as spouses of individuals without cancer.
Members of the group without a cancer diagnosis were individually matched to individuals in the group of people with spouses with cancer based on the year of birth, sex, and country. Spouses with and without preexisting psychiatric morbidity were analyzed separately.
Data analysis was performed between May 2021 and January 2022.
The main outcome was a clinical diagnosis of psychiatric disorders through hospital-based inpatient or outpatient care.
Among 546,321 spouses in the cancer group and 2,731,574 in the group without cancer who had no preexisting psychiatry morbidity, 46% were male participants with a median age at cohort entry of 60 years.
During a follow-up of approximately eight years, the incidence rate of first-onset psychiatric disorders was nearly 7 per 1,000 person-years in the cancer group and nearly 6 per 1,000 person-years in the non-cancer group.
“Depression, anxiety, and stress-related disorder are the most common psychiatric disorders among the spouses of cancer patients. This is consistent with distribution in the general population,” noted Hu.
The risk of first-onset psychiatric disorders increased by 30% during the first year after a cancer diagnosis, in particular for depression and stress-related disorders.
The risk of first-onset psychiatric disorders increased by 14% during the entire follow-up, which was similar for substance abuse, depression, and stress-related disorders.
The risk increase was more prominent among spouses of people diagnosed with a cancer with poor prognosis such as pancreatic cancer, or at an advanced stage and when the patient had died during follow-up.
Among spouses with preexisting psychiatric morbidity, the risk of psychiatric disorders increased by 23% during the entire follow-up period.
Hu added that the risks seemed to be higher for spouses between the ages of 40 and 80.
Heather Badt, LSS, is the executive director of research and training at the Cancer Support Community’s Research and Training Institute.
Badt is also a breast cancer survivor and her husband is an esophageal cancer survivor. She helped care for her husband while simultaneously managing her own cancer treatments.
She is not surprised by the study’s findings.
“There has been an increase in caregiver-specific support interventions, but access-to-care barriers are a key factor in caregivers not receiving needed help,” Badt told Healthline.
There is growing recognition that healthcare systems should evolve from a patient focus to a family focus, Badt said.
“We need better systems in place that support spouses of cancer patients and caregivers. Many of them just don’t have the services they need,” she said.
“We need more screening of the spouses for anxiety and helping with support tools. There are a million organizations, they are all over but many people just don’t know about it,” Badt added.
“Our study reinforces the importance of awareness among families of cancer patients, healthcare professionals, and the society at large regarding the vulnerability of cancer patients and their families, especially female cancer patients, patients with more aggressive type or advanced stage of cancer, and during the first year after a cancer diagnosis,” she said. “We advocate that spouses of cancer patients should be included in the surveillance and counseling of the cancer patients.”