Psychological morbidity associated with prostate cancer: Rates and predictors of depression in the RADICAL PC study

  • Gagan Fervaha University of Toronto
  • Jason P. Izard
  • Dean A. Tripp
  • Nazanin Aghel
  • Bobby Shayegan
  • Laurence Klotz
  • Tamim Niazi
  • Vincent Fradet
  • Daniel Taussky
  • Luke T. Lavallée
  • Robert J. Hamilton
  • Ian Brown
  • Joseph Chin
  • Darin Gopaul
  • Philippe D. Violette
  • Margot K. Davis
  • Sarah Karampatos
  • Jehonathan H. Pinthus
  • Darryl P. Leong
  • D. Robert Siemens
Keywords: Prostate carcinoma, Major Depressive Disorder, Quality of Life, Androgen Deprivation Therapy

Abstract

Introduction: Across all cancer sites and stages, prostate cancer has one of the greatest median five-year survival rates, highlighting the important focus on survivorship issues following diagnosis and treatment. In the current study, we sought to evaluate the prevalence and predictors of depression in a large, multicenter, contemporary, prospectively collected sample of men with prostate cancer.

Methods: Data from the current study were drawn from the baseline visit of men enrolled in the RADICAL PC study. Men with a new diagnosis of prostate cancer or patients initiating androgen deprivation therapy for prostate cancer for the first time were recruited. Depressive symptoms were evaluated using the nine-item version of the Patient Health Questionnaire (PHQ-9). To evaluate factors associated with depression, a multivariable logistic regression model was constructed, including biological, psychological, and social predictor variables.

Results: Data from 2445 patients were analyzed. Of these, 201 (8.2%) endorsed clinically significant depression. Younger age (odds ratio [OR] 1.38, 95% confidence interval [CI] 1.16–1.60 per 10-year decrease), being a current smoker (OR 2.77, 95% CI 1.66–4.58), former alcohol use (OR 2.63, 95% CI 1.33–5.20), poorer performance status (OR 5.01, 95% CI 3.49–7.20), having a pre-existing clinical diagnosis of depression or anxiety (OR 3.64, 95% CI 2.42–5.48), and having high-risk prostate cancer (OR 1.49, 95% CI 1.05–2.12) all conferred independent risk for depression.

Conclusions: Clinically significant depression is common in men with prostate cancer. Depression risk is associated with a host of biopsychosocial variables. Clinicians should be vigilant to screen for depression in those patients with poor social determinants of health, concomitant disability, and advanced disease.

Published
2020-11-17
How to Cite
Fervaha, G., Izard, J. P., Tripp, D. A., Aghel, N., Shayegan, B., Klotz, L., Niazi, T., Fradet, V., Taussky, D., Lavallée, L. T., Hamilton, R. J., Brown, I., Chin, J., Gopaul, D., Violette, P. D., Davis, M. K., Karampatos, S., Pinthus, J. H., Leong, D. P., & Siemens, D. R. (2020). Psychological morbidity associated with prostate cancer: Rates and predictors of depression in the RADICAL PC study. Canadian Urological Association Journal, 15(6), 181-6. https://doi.org/10.5489/cuaj.6912
Section
Original Research