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Anxiety and Depression in Patients with Prostate Cancer, at Cancer Diagnosis and after a One-Year Follow-Up. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159122. [PMID: 35897487 PMCID: PMC9368515 DOI: 10.3390/ijerph19159122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/14/2022] [Accepted: 07/20/2022] [Indexed: 02/04/2023]
Abstract
Prostate cancer (PCa) is the most prevalent among men, and psychological symptoms may affect many patients. This study aims to describe the prevalence of probable anxiety and depression before PCa treatments and after one year and to identify sociodemographic and clinical factors associated with these outcomes. Between February 2018 and March 2020, 292 patients recently diagnosed with PCa were recruited at the Instituto Português de Oncologia—Porto. The Hospital Anxiety and Depression Scale (HADS) was used to define probable anxiety and depression (cutoff = 11). The prevalence of probable anxiety remained stable from baseline to one year (7.8% vs. 8.5%, p = 0.866) while there was an increase in probable depression (3.1% vs. 6.8%, p = 0.012). After one year, probable depression persisted in 55.6% of patients with probable depression at baseline and 47.8% of those with probable anxiety at the first assessment had normal anxiety scores. At baseline, anxiety was more frequent among dwellers in rural areas (adjusted odds ratio—aOR, 95%CI: 2.80, 0.91–8.58) and less frequent in patients with body mass index 25–29.9 kg/m2 (aOR, 95%CI: 0.33, 0.12–0.91) compared to 18.5–24.9 Kg/m2, while those living alone had higher odds of depression (aOR, 95%CI: 6.35, 1.43–28.30). The frequency of anxiety and depression fluctuated during the course of treatment. Monitoring these symptoms would identify the most affected patients, contributing for a better use of mental health services.
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2
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Dordoni P, Remmers S, Valdagni R, Bellardita L, De Luca L, Badenchini F, Marenghi C, Roobol MJ, Venderbos LDF. Cross-cultural differences in men on active surveillance' anxiety: a longitudinal comparison between Italian and Dutch patients from the Prostate cancer Research International Active Surveillance study. BMC Urol 2022; 22:110. [PMID: 35850672 PMCID: PMC9295436 DOI: 10.1186/s12894-022-01062-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 07/11/2022] [Indexed: 11/10/2022] Open
Abstract
Background Men diagnosed with localized prostate cancer (PCa) on active surveillance (AS) have shown to cope with anxiety caused by living with an ‘untreated cancer’ and different factors can influence the tolerance level for anxiety in these patients. The present study analyzes Italian (Milan) and Dutch (Rotterdam) men prospectively included in the Prostate cancer International Active Surveillance (PRIAS) trial, aiming to explore whether socio-demographic factors (i.e. age, relationship status, education, nationality) may be relevant factors in conditioning the level of anxiety at AS entry and over time. Methods Italian and Dutch men participating in the IRB-approved PRIAS study, after signing an informed consent, filled in the Memorial Anxiety Scale for PCa (MAX-PC) at multiple time points after diagnosis. A linear mixed model was used to assess the relationship between the level of patient’s anxiety and time spent on AS, country of origin, the interaction between country and time on AS, patients’ relationship status and education, on PCa anxiety during AS. Results 823 MAX-PC questionnaires were available for Italian and 307 for Dutch men, respectively. Median age at diagnosis was 64 years (IQR 60–70 years) and did not differ between countries. On average, Dutch men had a higher total MAX-PC score than Italian men. However, the level of their anxiety decreased over time. Dutch men on average had a higher score on the PCa anxiety sub-domain, which did not decrease over time. Minimal differences were observed in the sub-domains PSA anxiety and fear of recurrence. Conclusion Significant differences in PCa anxiety between the Italian and Dutch cohorts were observed, the latter group of men showing higher overall levels of anxiety. These differences were not related to the socio-demographic factors we studied. Although both PRIAS-centers are dedicated AS-centers, differences in PCa-care organization (e.g. having a multidisciplinary team) may have contributed to the observed different level of anxiety at the start and during AS. Trial registration This study is registered in the Dutch Trial Registry (www.trialregister.nl) under NL1622 (registration date 11-03-2009), ‘PRIAS: Prostate cancer Research International: Active Surveillance—guideline and study for the expectant management of localized prostate cancer with curative intent’.
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Affiliation(s)
- Paola Dordoni
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Sebastiaan Remmers
- Department of Urology, Erasmus Cancer Institute, Erasmus University Medical Center, Wytemaweg 80, kamer Na-1520, 3015 CN, Rotterdam, The Netherlands
| | - Riccardo Valdagni
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - Lara Bellardita
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Letizia De Luca
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Fabio Badenchini
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Cristina Marenghi
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Monique J Roobol
- Department of Urology, Erasmus Cancer Institute, Erasmus University Medical Center, Wytemaweg 80, kamer Na-1520, 3015 CN, Rotterdam, The Netherlands
| | - Lionne D F Venderbos
- Department of Urology, Erasmus Cancer Institute, Erasmus University Medical Center, Wytemaweg 80, kamer Na-1520, 3015 CN, Rotterdam, The Netherlands.
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3
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Dinesh AA, Helena Pagani Soares Pinto S, Brunckhorst O, Dasgupta P, Ahmed K. Anxiety, depression and urological cancer outcomes: A systematic review. Urol Oncol 2021; 39:816-828. [PMID: 34503900 DOI: 10.1016/j.urolonc.2021.08.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/25/2021] [Accepted: 08/05/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE The interplay between physical and mental aspects of a cancer diagnosis are well recognised. However, little consensus exists on the impact of depression and anxiety on urological cancer outcomes. Therefore, this systematic review aimed to investigate the relationship between these conditions and functional or oncological outcomes in urological malignancy. MATERIALS AND METHODS A systematic search was conducted using PubMed, Embase, PsycINFO and Global Health databases up to June 2020. Studies evaluating the relationship of anxiety and depression disorders or symptoms on functional and mortality outcomes were included. Outcome measures included validated urinary, sexual, body image questionnaire scores and all-cause or disease-specific mortality. RESULTS Of 3,966 studies screened, 25 studies with a total of 175,047 urological cancer patients were included. Significant anxiety and depressive symptoms and disorders were found to impact functional outcomes in several cancer types. A consistent negative association existed for sexual function in prostate, testicular and penile cancer patients. Additionally, poorer urinary function scores were seen in prostate cancer, with increased body image issues in testicular and prostate cancer. Importantly, both overall and disease-specific mortality outcomes were poorer in bladder and prostate cancer patients. CONCLUSIONS Co-existing depression and anxiety appears to be negatively associated with functional and mortality outcomes in urological cancers. This appears especially evident in male cancers, including prostate and testicular cancer. Although not proving causation, these findings highlight the importance of considering mental wellbeing during follow-up for early recognition and treatment. However, current evidence remains heterogenous, with further studies required exploring patients at risk.
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Affiliation(s)
- Ayushi Anna Dinesh
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, United Kingdom
| | | | - Oliver Brunckhorst
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, United Kingdom
| | - Prokar Dasgupta
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, United Kingdom
| | - Kamran Ahmed
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, United Kingdom; Department of Urology, King's College Hospital, London, United Kingdom.
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4
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Rice SM, Kealy D, Ogrodniczuk JS, Seidler ZE, Montaner G, Chambers S, Oliffe JL. The Anxiety Depression Pathway Among Men Following a Prostate Cancer Diagnosis: Cross-Sectional Interactions Between Anger Responses and Loneliness. Am J Mens Health 2021; 15:15579883211023699. [PMID: 34142615 PMCID: PMC8216379 DOI: 10.1177/15579883211023699] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 05/17/2021] [Indexed: 11/15/2022] Open
Abstract
Anger has been a largely neglected emotion in prostate cancer research and intervention. This paper highlights the role of anger in the anxiety depression pathway among men with prostate cancer, and whether its impact is dependent on loneliness. Data are presented from a sample of men with prostate cancer (N = 105, M = 69.12 years, prostatectomy = 63.8%) and analysed using conditional process analysis. Dimensions of anger were evaluated as parallel mediators in bi-directional anxiety and depression pathways. Loneliness was evaluated as a conditional moderator of identified significant mediation relationships. Moderate severity depression (16.5%) was endorsed more frequently than moderate severity anxiety (8.6%, p = .008), with 19.1% of the sample reporting past two-week suicide ideation. Consistent with hypotheses, anger-related social interference (but not other dimensions of anger) significantly mediated the anxiety-depression pathway, but not the reverse depression-anxiety pathway. This indirect effect was conditional on men experiencing loneliness. Sensitivity analyses indicated the observed moderated mediation effect occurred for affective, but not somatic symptoms of depression. Findings support anger-related social interference (as opposed to anger frequency, intensity, duration or antagonism) as key to explaining the previously established anxiety-depression pathway. Results underscore the need for enhanced psychosocial supports for men with prostate cancer, with a particular focus on relational aspects. Supporting men with prostate cancer to adaptively process and manage their anger in ways that ameliorate negative social consequences will likely enhance their perceived social support quality, which may in turn better facilitate post-diagnosis recovery and emotional adjustment.
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Affiliation(s)
- Simon M. Rice
- Orygen, Parkville, Melbourne, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Australia
| | - David Kealy
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - John S. Ogrodniczuk
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Zac E. Seidler
- Orygen, Parkville, Melbourne, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Australia
| | - Gabriela Montaner
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Suzanne Chambers
- Faculty of Health Sciences, Australian Catholic University, Brisbane, Australia
- Faculty of Health, University of Technology Sydney, Sydney NSW, Australia
| | - John L. Oliffe
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
- Department of Nursing, The University of Melbourne, Australia
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5
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Brown SL, Fisher PL, Hope‐Stone L, Hussain RN, Heimann H, Damato B, Cherry MG. Predictors of long‐term anxiety and depression in uveal melanoma survivors: A cross‐lagged five‐year analysis. Psychooncology 2020; 29:1864-1873. [DOI: 10.1002/pon.5514] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/12/2020] [Accepted: 07/30/2020] [Indexed: 12/18/2022]
Affiliation(s)
- Stephen L. Brown
- Department of Psychological Sciences University of Liverpool Liverpool UK
| | - Peter L. Fisher
- Department of Psychological Sciences University of Liverpool Liverpool UK
- Clinical Health Psychology Service, Linda McCartney Centre Royal Liverpool and Broadgreen University Hospital NHS Trust UK
| | - Laura Hope‐Stone
- Department of Psychological Sciences University of Liverpool Liverpool UK
- Clinical Health Psychology Service, Linda McCartney Centre Royal Liverpool and Broadgreen University Hospital NHS Trust UK
- Liverpool Ocular Oncology Centre Royal Liverpool and Broadgreen University Hospital NHS Trust UK
| | - Rumana N. Hussain
- Liverpool Ocular Oncology Centre Royal Liverpool and Broadgreen University Hospital NHS Trust UK
| | - Heinrich Heimann
- Liverpool Ocular Oncology Centre Royal Liverpool and Broadgreen University Hospital NHS Trust UK
| | - Bertil Damato
- Liverpool Ocular Oncology Centre Royal Liverpool and Broadgreen University Hospital NHS Trust UK
| | - M. Gemma Cherry
- Department of Psychological Sciences University of Liverpool Liverpool UK
- Clinical Health Psychology Service, Linda McCartney Centre Royal Liverpool and Broadgreen University Hospital NHS Trust UK
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6
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Brown SL, Hope-Stone L, Heimann H, Damato B, Salmon P. Predictors of anxiety and depression 2 years following treatment in uveal melanoma survivors. Psychooncology 2018; 27:1727-1734. [DOI: 10.1002/pon.4715] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 03/08/2018] [Accepted: 03/17/2018] [Indexed: 02/03/2023]
Affiliation(s)
- Stephen L. Brown
- Institute of Psychology, Health and Society; University of Liverpool; Liverpool UK
| | - Laura Hope-Stone
- Institute of Psychology, Health and Society; University of Liverpool; Liverpool UK
- Liverpool Ocular Oncology Centre; Royal Liverpool and Broadgreen University Hospital, NHS Trust; Liverpool UK
| | - Heinrich Heimann
- Liverpool Ocular Oncology Centre; Royal Liverpool and Broadgreen University Hospital, NHS Trust; Liverpool UK
| | - Bertil Damato
- Liverpool Ocular Oncology Centre; Royal Liverpool and Broadgreen University Hospital, NHS Trust; Liverpool UK
- Ocular Oncology Service; University of California; San Francisco CA USA
| | - Peter Salmon
- Institute of Psychology, Health and Society; University of Liverpool; Liverpool UK
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7
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Ruane-McAteer E, Porter S, O'Sullivan JM, Santin O, Prue G. Active surveillance for favorable-risk prostate cancer: Is there a greater psychological impact than previously thought? A systematic, mixed studies literature review. Psychooncology 2016; 26:1411-1421. [PMID: 27862602 DOI: 10.1002/pon.4311] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 09/30/2016] [Accepted: 11/11/2016] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Active surveillance (AS) allows men with favorable-risk prostate cancer to avoid or postpone active treatment and hence spares potential adverse effects for a significant proportion of these patients. Active surveillance may create an additional emotional burden for these patients. The aim of the review was to determine the psychological impact of AS to inform future study in this area and to provide recommendations for clinical practice. METHODS Studies were identified through database searching from inception to September 2015. Quantitative or qualitative noninterventional studies published in English that assessed the psychological impact of AS were included. The Mixed Methods Appraisal Tool was used to assess methodological quality. RESULTS Twenty-three papers were included (20 quantitative and 3 qualitative). Quantitatively, the majority of patients do not report psychological difficulties; however, when appropriateness of study design is considered, the conclusion that AS has minimal impact on well-being may not be accurate. This is due to small sample sizes, inappropriately timed baseline, and inappropriate/lack of comparison groups. In addition, a mismatch in outcome was noted between the outcome of quantitative and qualitative studies in uncertainty, with qualitative studies indicating a greater psychological impact. CONCLUSIONS Because of methodological concerns, many quantitative studies may not provide a true account of the burden of AS. Further mixed-methods studies are necessary to address the limitations highlighted and to provide clarity on the impact of AS. Practitioners should be aware that despite findings of previous reviews, patients may require additional emotional support.
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Affiliation(s)
- Eimear Ruane-McAteer
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University Belfast, Belfast, UK
| | - Sam Porter
- Department of Social Sciences and Social Work, Bournemouth University, Bournemouth, UK
| | - Joe M O'Sullivan
- Centre for Cancer Research and Cell Biology (CCRCB), Queen's University Belfast, Belfast, UK.,The Northern Ireland Cancer Centre (NICC), Belfast City Hospital, Belfast, UK
| | - Olinda Santin
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University Belfast, Belfast, UK
| | - Gillian Prue
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University Belfast, Belfast, UK
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8
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Sullivan DR, Mongoue-Tchokote S, Mori M, Goy E, Ganzini L. Randomized, double-blind, placebo-controlled study of methylphenidate for the treatment of depression in SSRI-treated cancer patients receiving palliative care. Psychooncology 2016; 26:1763-1769. [PMID: 27429350 DOI: 10.1002/pon.4220] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 06/17/2016] [Accepted: 07/10/2016] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To determine the effectiveness of methylphenidate for depression treatment in patients with advanced cancer. DESIGN An 18-day randomized, double-blind, placebo-controlled clinical trial of methylphenidate for treatment of depression in selective serotonin reuptake inhibitor-treated patients with advanced cancer in hospice or receiving palliative care. The primary outcome was depression remission, defined as a ≥50% reduction in score on the Montgomery-Asberg Depression Rating Scale. RESULTS Among 47 enrolled participants, 34 were randomized. At study day 18, 85% of the methylphenidate and 60% of the placebo group were in depression remission (P = .22). Mean time to depression remission was 10.3 days [standard error (SE) 1.8] in the methylphenidate and 8.1 (SE 1.3) in the placebo group (P = .48). The mean baseline score for the Hospital Anxiety and Depression Scale (HADS) was 10.4 in each group and decreased by 3.6 (SE 1.1) in the methylphenidate and 2.3 (SE 1.2) in the placebo group (P = .51) by day 18. Once in remission, 1 methylphenidate and 5 placebo participants relapsed to depression (P = .18). There was no difference in mortality between the groups during the trial. Trial results were limited by small sample size attributed to difficulties in recruiting terminally ill patients. CONCLUSIONS This trial failed to demonstrate that methylphenidate treatment in selective serotonin reuptake inhibitor-treated patients had a significant effect on depression remission in patients with advanced cancer. This study underscores the difficulties in conducting trials for symptom management in patients with shortened life expectancy.
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Affiliation(s)
- Donald R Sullivan
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Oregon Health and Science University, Portland, OR, USA.,Health Services Research and Development, Veterans Affairs Portland Health Care System, Portland, OR, USA
| | - Solange Mongoue-Tchokote
- Knight Cancer Institute, Biostatistics Shared Resource, Oregon Health and Science University, Portland, OR, USA
| | - Motomi Mori
- School of Public Health, Oregon Health and Science University and Portland State University, Portland, OR, USA
| | - Elizabeth Goy
- Mental Health and Clinical Neurosciences Division, Veterans Affairs Portland Health Care System, Portland, OR, USA.,Division of Geriatric Psychiatry, Department of Psychiatry, Oregon Health and Science University, Portland, OR, USA
| | - Linda Ganzini
- Health Services Research and Development, Veterans Affairs Portland Health Care System, Portland, OR, USA.,Mental Health and Clinical Neurosciences Division, Veterans Affairs Portland Health Care System, Portland, OR, USA.,Division of Geriatric Psychiatry, Department of Psychiatry, Oregon Health and Science University, Portland, OR, USA
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9
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Drummond FJ, O'Leary E, Gavin A, Kinnear H, Sharp L. Mode of prostate cancer detection is associated with the psychological wellbeing of survivors: results from the PiCTure study. Support Care Cancer 2016; 24:2297-2307. [PMID: 26594035 PMCID: PMC4805717 DOI: 10.1007/s00520-015-3033-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 11/15/2015] [Indexed: 12/14/2022]
Abstract
PURPOSE Many men with prostate cancer are asymptomatic, diagnosed following prostate specific antigen (PSA) testing. We investigate whether mode of detection, i.e. 'PSA detected' or 'clinically detected', was associated with psychological wellbeing among prostate cancer survivors. METHODS A cross-sectional postal questionnaire was administered in 2012 to 6559 prostate cancer (ICD10 C61) survivors up to 18 years post-diagnosis, identified through population-based cancer registries in Ireland. Psychological wellbeing was assessed using the Depression Anxiety Stress Scale-21. Logistic regression was used to investigate associations between mode of detection and depression, anxiety and stress, adjusting for socio-demographic and clinical confounders. RESULTS The response rate was 54 % (3348/6262). Fifty-nine percent of survivors were diagnosed with asymptomatic PSA-tested disease. Prevalence of depression (13.8 vs 20.7 %; p < 0.001), anxiety (13.6 vs 20.9 %; p < 0.001) and stress (8.7 vs 13.8 %; p < 0.001) were significantly lower among survivors diagnosed with PSA-detected, than clinically detected disease. After adjusting for clinical and socio-demographic factors, survivors with clinically detected disease had significantly higher risk of depression (odds ratio (OR) = 1.46 95 % CI 1.18, 1.80; p = 0.001), anxiety (OR = 1.36 95 % CI 1.09, 1.68; p = 0.006) and stress (OR = 1.43 95 % CI 1.11, 1.85; p = 0.006) than survivors with PSA-detected disease. CONCLUSIONS These findings contribute to the ongoing debate on benefits and risks of PSA testing and may be considered by policy makers formulating population-based prostate cancer screening policies. The relatively high prevalence of negative psychological states among survivors means that a 'risk-adapted approach' should be implemented to screen survivors most at risk of psychological morbidity for psychological health, and mode of detection could be considered as a risk stratum.
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Affiliation(s)
- Frances J Drummond
- National Cancer Registry Ireland, Building 6800, Airport Business Park, Kinsale Road, Cork, Ireland.
- School of Nursing and Midwifery, University College Cork, Cork, Ireland.
| | - Eamonn O'Leary
- National Cancer Registry Ireland, Building 6800, Airport Business Park, Kinsale Road, Cork, Ireland
| | - Anna Gavin
- Northern Ireland Cancer Registry, Centre for Public Health, Queen's University Belfast, Mulhouse Building, Grosvenor Road, Belfast, BT12 6BJ, Ireland
| | - Heather Kinnear
- Northern Ireland Cancer Registry, Centre for Public Health, Queen's University Belfast, Mulhouse Building, Grosvenor Road, Belfast, BT12 6BJ, Ireland
| | - Linda Sharp
- National Cancer Registry Ireland, Building 6800, Airport Business Park, Kinsale Road, Cork, Ireland
- University of Newcastle, Tyne and Wear, Newcastle upon Tyne, NE1 7RU, UK
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10
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Hunter MS, Sharpley CF, Stefanopoulou E, Yousaf O, Bitsika V, Christie DRH. The Hot Flush Beliefs and Behaviour Scale for Men (HFBBS-Men) undergoing treatment for prostate cancer. Maturitas 2014; 79:464-70. [PMID: 25449665 DOI: 10.1016/j.maturitas.2014.09.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 09/16/2014] [Accepted: 09/29/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Hot flushes and night sweats (HFNS) are commonly experienced by men receiving treatment for prostate cancer. Cognitive behavioural therapy (CBT) has been found to be an effective treatment for HFNS in women, but cognitions and behavioural reactions to HFNS in men are under-researched. This study describes the development of the HFNS beliefs and behaviour scale for men. METHODS HFNS beliefs and behaviour items were generated from a qualitative study, from pilot interviews with men with prostate cancer and HFNS, and from scales used for women. 118 men with prostate cancer, aged above 18, English-speaking, who had minimum of seven HFNS weekly for at least 1 month, completed the initial measure, and measures of HFNS frequency, problem rating, anxiety and depression (HADS). Principal components analyses with orthogonal rotation determined the most coherent solution. RESULTS Exploratory factor analysis culminated in a 17-item HFNS beliefs and behaviour scale for men (HFBBS-Men) with three subscales: (1) HFNS social context and sleep, (2) Calm/Acceptance, (3) Humour/Openness. The subscales had reasonable internal consistency (Cronbach alpha 0.56-0.83). Validity was supported, by correlations between subscale 1, HFNS frequency, problem-rating and mood; men with locally advanced cancer more likely to adopt Calm/Acceptance and those with metastatic cancer Humour/Openness. CONCLUSIONS Preliminary analysis of the HFBBS-Men suggests that it is a psychometrically sound instrument, grounded in men's experiences. As a measure of cognitive and behavioural reactions to HF/NS, the HFBBS-Men should increase understanding of the mediators of outcomes of psychological interventions, such as CBT.
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Affiliation(s)
- M S Hunter
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
| | - C F Sharpley
- Brain-Behaviour Research Group, University of New England, New South Wales, Australia; Centre for Autism Spectrum Disorders, Bond University, Queensland, Australia
| | - E Stefanopoulou
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - O Yousaf
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - V Bitsika
- Centre for Autism Spectrum Disorders, Bond University, Queensland, Australia
| | - D R H Christie
- Brain-Behaviour Research Group, University of New England, New South Wales, Australia; GenesisCare, Queensland, Australia
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11
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Sharpley CF, Bitsika V, Christie DRH. Diagnosing 'male' depression in men diagnosed with prostate cancer: the next step in effective translational psycho-oncology interventions? Psychooncology 2014; 23:1042-8. [PMID: 24700681 DOI: 10.1002/pon.3530] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 02/24/2014] [Accepted: 02/28/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND Depression in men diagnosed with prostate cancer is associated with several adverse outcomes. However, some data suggest that standard methods of assessing depression in males via the criteria for Major Depressive Disorder (MDD) may omit several extra key symptoms of male depression. Therefore, this study tested the comparative effects of standard MDD-based diagnostic criteria for depression and criteria for 'male depression' in a sample of men diagnosed with prostate cancer. METHOD 191 men diagnosed with prostate cancer completed a postal survey questionnaire containing questions about background variables, the Patient Health Questionnaire-9 for depression (PHQ9) and the Gotland Male Depression Scale (GMDS). Comparisons were made of the relative prevalence of depression according to these scales, plus a scale that combined the PHQ9 and GMDS extra items for male depression RESULTS Although there were significant correlations between total PHQ9 and GMDS scores, over one-third of variance in the GMDS was not accounted for by the PHQ9, and sensitivity of the PHQ9 against the GMDS showed that about 24% of those patients identified as depressed on the GMDS would not be similarly identified on the PHQ9. Different prevalence rates from the two scales suggested that they were assessing different sets of symptoms of depression. A combined PHQ9-GMDS scale of 15 items was used to produce a profile of male depression in these patients. CONCLUSION Adequate and reliable assessment of depression in men diagnosed with prostate cancer may require use of additional symptoms to those listed for MDD, and treatment planning and delivery could be more precise and effective using this methodology.
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12
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Punnen S, Cowan JE, Dunn LB, Shumay DM, Carroll PR, Cooperberg MR. A longitudinal study of anxiety, depression and distress as predictors of sexual and urinary quality of life in men with prostate cancer. BJU Int 2013; 112:E67-75. [PMID: 23795800 DOI: 10.1111/bju.12209] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate the prevalence of depression, anxiety and distress among active surveillance (AS) and radical prostatectomy (RP) patients. To evaluate the impact of these symptoms at baseline on urinary and sexual quality of life at follow-up. PATIENTS AND METHODS Patients managed with AS or RP who completed validated questionnaires assessing levels of depression, anxiety, distress and urinary (UF) and sexual function (SF) and bother comprised the final analytic cohort. These measures were completed at baseline, within 1 year, and between 1 and 3 years from baseline. Mixed model repeated measures analysis was used to examine associations between mental health at baseline and sexual and urinary outcomes in a subset of RP patients with complete follow-up. RESULTS Among 679 men who comprised the study cohort, baseline prevalence of moderate or higher levels of depression or anxiety were low (<5%), while levels of mild depression or anxiety ranged from 3-16% over time. Baseline levels of elevated distress ranged from 8-20%. Among men who provided data at baseline and follow-up, there were no significant differences between AS and RP patients in the proportion of men with elevated levels of depression, anxiety, or distress. Among 177 men who underwent RP and had complete follow-up moderate or higher levels of depression or anxiety appeared to be associated with post-treatment SF and bother, while elevated levels of distress were associated with post-treatment UF. CONCLUSION Moderate or higher levels of depression or anxiety were low in men with localised prostate cancer but were associated with sexual outcomes, while elevated distress was associated with urinary outcomes. Greater attention should be paid to mental health symptoms among men with prostate cancer, as these symptoms may be associated with quality of life outcomes.
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Affiliation(s)
- Sanoj Punnen
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA 94143-1695, USA.
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13
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Do hormone treatments for prostate cancer cause anxiety and depression? Int J Clin Oncol 2013; 19:523-30. [DOI: 10.1007/s10147-013-0569-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 05/09/2013] [Indexed: 10/26/2022]
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14
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Glaser AP, Novakovic K, Helfand BT. The Impact of Prostate Biopsy on Urinary Symptoms, Erectile Function, and Anxiety. Curr Urol Rep 2012; 13:447-54. [DOI: 10.1007/s11934-012-0277-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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15
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Sharpley CF, Bitsika V, Christie DRH. Do patient-reported androgen-deprivation therapy side effects predict anxiety and depression among prostate cancer patients undergoing radiotherapy? Implications for psychosocial therapy interventions. J Psychosoc Oncol 2012; 30:185-97. [PMID: 22416955 DOI: 10.1080/07347332.2011.651261] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Antiandrogen therapy (AAT) is a common adjunct treatment for prostate cancer (PCa) patients and has shown significant benefits to long-term outcomes from radiation or surgery. Although AAT has some adverse side effects and data from breast cancer patients indicate that such side effects from hormonal therapies may contribute to anxiety and depression and may also hinder AAT treatment compliance, this issue has not been investigated within a sample of PCa patients. This study explores the incidence of AAT side effects in a sample of PCa patients, the links between those side effects and anxiety and depression, the possible ways in which these factors may contribute to AAT treatment noncompliance in PCa patients, and how psychosocial treatments might be developed to attend to this issue. 147 PCa patients completed questionnaires on demographic factors, treatment compliance, AAT side effects, anxiety and depression. About 18% of the sample reported AAT side effects, and there was a significant association between the presence of side effects and elevated anxiety and depression scores. Increased frequency of side effects was significantly associated with elevated anxiety, but not depression. The most powerful relationship between AAT side effects and anxiety-depression was for the subfactors of (1) Fatigue, Pain and Discomfort, and (2) Psychological Agitation and Pessimism. Although fatigue, pain, and discomfort may be outcomes of the hormonal treatment itself, psychological agitation and pessimism represent a discrete psychological pathway between AAT side effects and anxiety and depression and (potentially) treatment noncompliance. Methods of addressing patients' loss of optimism in their treatment outcomes are discussed.
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Affiliation(s)
- Christopher F Sharpley
- Brain-Behaviour Research Group, University of New England, Coolangatta, New South Wales, Australia.
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16
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Helfand BT, Glaser AP, Rimar K, Zargaroff S, Hedges J, McGuire BB, Catalona WJ, McVary KT. Prostate cancer diagnosis is associated with an increased risk of erectile dysfunction after prostate biopsy. BJU Int 2012; 111:38-43. [DOI: 10.1111/j.1464-410x.2012.11268.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Brian T. Helfand
- Department of Urology; Feinberg School of Medicine; Northwestern University; Chicago; IL; USA
| | - Alexander P. Glaser
- Department of Urology; Feinberg School of Medicine; Northwestern University; Chicago; IL; USA
| | - Kalen Rimar
- Department of Urology; Feinberg School of Medicine; Northwestern University; Chicago; IL; USA
| | - Sherwin Zargaroff
- Department of Urology; Feinberg School of Medicine; Northwestern University; Chicago; IL; USA
| | - Jason Hedges
- Department of Urology; Feinberg School of Medicine; Northwestern University; Chicago; IL; USA
| | - Barry B. McGuire
- Department of Urology; Feinberg School of Medicine; Northwestern University; Chicago; IL; USA
| | - William J. Catalona
- Department of Urology; Feinberg School of Medicine; Northwestern University; Chicago; IL; USA
| | - Kevin T. McVary
- Department of Urology; Feinberg School of Medicine; Northwestern University; Chicago; IL; USA
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17
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Segrin C, Badger TA, Figueredo AJ. Stage of disease progression moderates the association between social support and depression in prostate cancer survivors. J Psychosoc Oncol 2012; 29:552-60. [PMID: 21882934 DOI: 10.1080/07347332.2011.599362] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This study was designed to test the association between social support and depression at different stages of disease progression in men with prostate cancer.Seventy-one men with prostate cancer completed measures of social support and depression three times: T1 (at baseline), T2 (T1 + 2 months), and at T3 (T1 + 4 months). Stage of disease progression was significantly associated with increasing symptoms of depression. Stage of disease progression also moderated the association between social support and depression. Social support was associated with a subsequent worsening of depression for men with early-stage disease. For men with more advanced prostate cancer, social support was associated with improvements in subsequent depression. Social support has different prognostic value for psychological distress among men with prostate cancer depending upon the stage of their disease.
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Affiliation(s)
- Chris Segrin
- Department of Communication, The University of Arizona, Tucson, AZ 85721, USA.
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18
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Sharpley CF, Bitsika V, Christie DR. The role of Melancholia in prostate cancer patients' depression. BMC Psychiatry 2011; 11:201. [PMID: 22185620 PMCID: PMC3278360 DOI: 10.1186/1471-244x-11-201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Accepted: 12/20/2011] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Although it is well established that prostate cancer (PCa) patients are more likely to experience clinical depression than their age-matched non-prostate cancer peers, and that such depression can have negative effects upon survival, little is known about the underlying nature of the depressive symptomatology that these men experience. In particular, the incidence of melancholic symptoms of depression, which are signs of increased risk of suicide and resistance to treatment, has not previously been reported in PCa patients. The present study aimed to measure the incidence and nature of Melancholia in PCa depression. METHOD A sample of 507 PCa patients in Queensland, Australia, completed anonymous and confidential questionnaires about their background, treatment status, and depression. Data were analysed to select depressive symptoms that were part of the definition of Melancholia vs those which were not. Regression was used to determine the links between Melancholia and overall depressive status, and factor analysis revealed the underlying components of Melancholia, which were mapped over time since diagnosis for 3 years. RESULTS Psychometric data were satisfactory. Melancholia significantly predicted depressive status for the most depressed subset of patients, but not for the total sample. Melancholia was factored into its components of Anhedonia and Agitation, and the first of these was more powerful in predicting Melancholia. Variability over the 3 years following diagnosis was noted for each of these two components of Melancholia. CONCLUSIONS The strong presence of Melancholia in the depressive symptomatology of this sample of PCa patients suggests that some forms of treatment for depression may be more likely to succeed than others. The dominance of Anhedonia and Agitation over other symptoms of Melancholia also holds implications for treatment options when assisting these men to cope with their depression.
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Affiliation(s)
- Christopher F Sharpley
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales 2351, Australia
| | - Vicki Bitsika
- Brain-Behaviour Research Group, Bond University, Gold Coast, Robina, Queensland 4229, Australia
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Mohamed NE, Bovbjerg DH, Montgomery GH, Hall SJ, Diefenbach MA. Pretreatment depressive symptoms and treatment modality predict post-treatment disease-specific quality of life among patients with localized prostate cancer. Urol Oncol 2011; 30:804-12. [PMID: 21795078 DOI: 10.1016/j.urolonc.2011.02.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2010] [Revised: 01/26/2011] [Accepted: 02/06/2011] [Indexed: 11/15/2022]
Abstract
PURPOSE This study examines the prevalence of depressive symptoms before prostate cancer treatment and explores associations among pre-treatment depressive symptoms and post-treatment disease-specific QOL, controlling for treatment modality, and demographic and clinical covariates. MATERIALS AND METHODS A case series of patients diagnosed with localized prostate cancer (T1-2N0M0) at a comprehensive cancer center was assessed. Of the 1,370 eligible patients, 869 (63.34%) completed questionnaires at diagnosis (baseline) and 6 months following treatment. Patients were treated with surgery (16.8%), brachytherapy (27.6%), or external beam radiation (EBRT; 55.6%). Depressive symptoms and disease-specific QOL were assessed with established measures (i.e., Center for Epidemiologic Studies Depression Scale (CES-D); sexual adjustment questionnaire (SAQ); and the American Urological Association symptom index). RESULTS A fifth of the sample (19.7%) reported clinically elevated levels of depressive symptoms at baseline. The proportion of clinically elevated levels of baseline depressive symptoms was higher among surgery patients compared with patients treated with brachytherapy or external beam radiation. Depressive symptoms at baseline and treatment modality significantly predicted sexual and urinary dysfunction, related bother, activity limitation due to urinary dysfunction at 6 months, controlling for, age, PSA level, Gleason score, relevant baseline indicators of sexual and urinary dysfunction, related bother, and activity limitation (P < 0.05). CONCLUSIONS Pretreatment depressive symptoms and treatment modality predict QOL after PrCa treatment. Health care providers should be sensitive to the display of depressive symptoms before PrCa treatment and consider preventative interventions, including preparing patients for the changes in disease-specific QOL and related bother following prostate cancer treatment.
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Affiliation(s)
- Nihal E Mohamed
- Department of Urology, Mount Sinai School of Medicine, New York, NY 10029, USA.
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