Rice Simon M, Kealy David, Ogrodniczuk John S, Seidler Zac E, Denehy Linda, Oliffe John L
Orygen, Melbourne, VIC, Australia.
Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia.
Cancer Manag Res. 2020 Feb 11;12:1039-1046. doi: 10.2147/CMAR.S237770. eCollection 2020.
Prostate cancer is a risk factor for major depressive disorder. Recent psycho-oncology research suggests a potential role for male-specific mood-related symptoms in this relationship. Gender socialisation experiences may reinforce men's anger and emotion suppression responses in times of distress, and anger and emotion suppression may be implicated in pathways to, and maintenance of depression in prostate cancer.
Data were collected online from men with a self-reported diagnosis of prostate cancer (N=100; mean age 64.8 years). Respondents provided information regarding diagnosis and treatment, in addition to current experience of major depression and male-specific externalising symptoms.
Prostate cancer diagnosis in the last 12 months occurred for 35.4% of the sample. Elevated major depression symptoms were observed for 49% of respondents, with 14% endorsing past 2-week suicide ideation. Parallel mediation analysis (99% CIs) controlling for prostatectomy and active surveillance indicated men's emotion suppression mediated the relationship between anger and depression symptoms ( =0.580). Trichotimised emotion suppression scores with control variables yielded a large multivariate effect (<0.001, partial =0.199). Univariate moderate-sized effects were observed for emotion suppression comparisons for symptoms of depressed mood and sleep disturbance, and a large effect observed for guilt-proneness.
Findings highlight the salience of anger in the experience of depression symptoms for men with prostate cancer. The mediating role of emotion suppression, which in turn was strongly linked to men's feelings of guilt, suggests potential assessment and intervention targets. Future work should examine the role of androgen deprivation therapy and other treatments including active surveillance on the relationship between anger and depression in men with prostate cancer. Consideration of interventions focused on emotion processing skills in psycho-oncology settings may help reduce men's reliance on emotion suppression as a strategy for coping with feelings of anger or guilt in the context of prostate cancer.
前列腺癌是重度抑郁症的一个风险因素。近期的心理肿瘤学研究表明，男性特有的情绪相关症状在这种关系中可能发挥潜在作用。性别社会化经历可能会强化男性在困境中的愤怒和情绪抑制反应，而愤怒和情绪抑制可能与前列腺癌患者抑郁症的发生及维持途径有关。
通过在线方式收集了自我报告诊断为前列腺癌的男性的数据（N = 100；平均年龄64.8岁）。除了当前的重度抑郁经历和男性特有的外化症状外，受访者还提供了有关诊断和治疗的信息。
35.4%的样本在过去12个月内被诊断为前列腺癌。49%的受访者存在重度抑郁症状升高的情况，其中14%的人认可过去两周有自杀念头。在控制前列腺切除术和积极监测的平行中介分析（99%置信区间）中，男性的情绪抑制介导了愤怒与抑郁症状之间的关系（β = 0.580）。将情绪抑制得分进行三分并纳入控制变量后，产生了较大的多变量效应（p < 0.001，偏相关系数 = 0.199）。在情绪抑制与抑郁情绪症状和睡眠障碍症状的比较中观察到单变量中等效应，而在易内疚方面观察到较大效应。
研究结果突出了愤怒在前列腺癌男性抑郁症状体验中的显著性。情绪抑制的中介作用，而情绪抑制又与男性的内疚感密切相关，提示了潜在的评估和干预靶点。未来的研究应考察雄激素剥夺疗法和其他治疗方法（包括积极监测）在前列腺癌男性愤怒与抑郁关系中的作用。考虑在心理肿瘤学环境中开展专注于情绪处理技能的干预措施，可能有助于减少男性在前列腺癌背景下将情绪抑制作为应对愤怒或内疚情绪策略的依赖。
