Psychological distress in prostate cancer

Validation of the K10 scale using a crossover randomized clinical trial

Auteurs-es

  • Wyatt MacNevin Department of Urology, Dalhousie University, 5849 University Avenue, Halifax, Nova Scotia, Canada
  • Ryan Lukic Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, 5790 University Avenue, Halifax, Nova Scotia, Canada
  • Gabriela Ilie Department of Urology, Dalhousie University, 5849 University Avenue, Halifax, Nova Scotia, Canada. Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, 5790 University Avenue, Halifax, Nova Scotia, Canada. Department of Radiation Oncology, Faculty of Medicine, Dalhousie University, 5489 University Avenue, Halifax, Nova Scotia.
  • Ricardo A. Rendon Department of Urology, Dalhousie University, 5849 University Avenue, Halifax, Nova Scotia, Canada
  • Ross J. Mason Department of Urology, Dalhousie University, 5849 University Avenue, Halifax, Nova Scotia, Canada
  • Andrea Kokorovic Department of Urology, Dalhousie University, 5849 University Avenue, Halifax, Nova Scotia, Canada
  • Greg Bailly Department of Urology, Dalhousie University, 5849 University Avenue, Halifax, Nova Scotia, Canada
  • Nikhilesh Patil Department of Radiation Oncology, Faculty of Medicine, Dalhousie University, 5489 University Avenue, Halifax, Nova Scotia, Canada
  • David Bowes Department of Radiation Oncology, Faculty of Medicine, Dalhousie University, 5489 University Avenue, Halifax, Nova Scotia, Canada
  • Robert David Harold Rutledge Department of Radiation Oncology, Faculty of Medicine, Dalhousie University, 5489 University Avenue, Halifax, Nova Scotia, Canada

DOI :

https://doi.org/10.5489/cuaj.9294

Mots-clés :

Prostate Cancer, Psychological Distress, Anxiety, Depression, Screening Tool

Résumé

INTRODUCTION: Men diagnosed with prostate cancer (PCa) experience substantial psychological distress. Despite this, the use of screening tools in this population is limited and understudied. This study evaluates the validity of the Kessler Psychological Distress Scale (K10) as a psychological distress screening tool in men undergoing curative PCa treatment.

METHODS: Participants in a PCa psychological distress prevention program (n=128) were assessed at baseline, six months, and 12 months using the K10. Exploratory (EFA) and confirmatory factor analysis (CFA) examined the scale’s factor structure. Receiver operating characteristic (ROC) analyses evaluated sensitivity, specificity, and predictive values for depression and anxiety. Logistic regression assessed the impact of cutoffs on clinical psychological distress.

RESULTS: EFA identified a single-factor structure (factor loadings: 0.59–0.96, variance explained: 76%). CFA confirmed model-fit (comparative fit index 0.905; standardized root mean square residual 0.042). ROC analysis demonstrated excellent predictive ability (area under the curve [AUC] 0.98, 95% confidence interval [CI] 0.95–1.0 for depression; 0.92, 95% CI 0.86–0.98 for anxiety). Youden’s index suggested K10 thresholds of ≥17.5 (depression) and ≥16.5 (anxiety), although these cutoffs lacked sensitivity. With standard K10≥20 cutoffs, significant differences were observed between intervention and control groups at six months (adjusted odds ratio [aOR] 3.59, 95% CI 1.12–11.51, p=0.031) and 12 months (aOR 4.41, 95% CI 1.35–4.41, p=0.014), consistent with prior findings.

CONCLUSIONS: The K10 is valid and reliable for this population, demonstrating excellent internal consistency; however, lower cutoffs (K10≥16.5, K10≥17.5) may reduce sensitivity. The standard K10≥20 threshold remains preferable for detecting distress and evaluating intervention effects in men with PCa.

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Publié-e

2025-09-23

Comment citer

MacNevin, W., Lukic, R., Ilie, G., Rendon, R. . A., Mason, R. J., Kokorovic, A., … Rutledge, R. D. H. (2025). Psychological distress in prostate cancer: Validation of the K10 scale using a crossover randomized clinical trial. Canadian Urological Association Journal, 20(1), E8–15. https://doi.org/10.5489/cuaj.9294

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Original Research