Pirl William F, Siegel Gabrielle I, Goode Melissa J, Smith Matthew R
Psychiatry Department, The Massachusetts General Hospital, Boston, MA 02114, USA.
Psychooncology. 2002 Nov-Dec;11(6):518-23. doi: 10.1002/pon.592.
Prostate cancer is the most common malignancy in men and one of the leading causes of cancer death in men internationally. Treatment for prostate cancer frequently includes androgen deprivation therapy (ADT). Reports of depressive symptoms arising during ADT are emerging. This study examines the prevalence rates and risk factors associated with major depression in this population.
45 men with prostate cancer receiving ADT at the MGH Cancer Center were surveyed for depression with the SCID for Axis I disorders for DSM-IV and the Beck Depression Inventory.
Major depressive disorder was prevalent in 12.8% of the men with prostate cancer receiving ADT, eight times the national rate of depression in men, 32 times the rate in men over 65 years old. Major depression was not associated with worsening disease, medical response to ADT, receiving chemotherapy, or the type of ADT. Past history of depression was associated with current depression in this population (p<0.000). No first onset cases of depression occurred on ADT in this sample.
This data suggests a significant rate of major depression in men with prostate cancer receiving ADT and that men with past histories of depression may be at particular risk for recurrence of their depression while undergoing this treatment.
前列腺癌是男性中最常见的恶性肿瘤，也是全球男性癌症死亡的主要原因之一。前列腺癌的治疗通常包括雄激素剥夺疗法（ADT）。有关ADT期间出现抑郁症状的报告不断涌现。本研究调查了该人群中重度抑郁症的患病率及相关危险因素。
对麻省总医院癌症中心45名接受ADT的前列腺癌男性患者进行了调查，使用《精神疾病诊断与统计手册》第四版轴I障碍的结构性临床访谈（SCID）和贝克抑郁量表评估抑郁情况。
在接受ADT的前列腺癌男性患者中，重度抑郁症的患病率为12.8%，是男性全国抑郁症患病率的8倍，65岁以上男性患病率的32倍。重度抑郁症与疾病恶化、ADT的医学反应、接受化疗或ADT类型无关。在该人群中，既往抑郁史与当前抑郁有关（p<0.000）。本样本中未出现ADT期间首次发作抑郁症的病例。
该数据表明，接受ADT的前列腺癌男性中重度抑郁症的发生率较高，且有抑郁病史的男性在接受该治疗时可能特别容易复发抑郁症。
