Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.
Oncology Clinic, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Psychooncology. 2020 Oct;29(10):1604-1612. doi: 10.1002/pon.5471. Epub 2020 Jul 29.
In order to optimize psycho-oncological care, studies that quantify the extent of distress and identify certain risk groups are needed. Among patients with prostate cancer (PCa), findings on depression and anxiety are limited.
We analyzed data of PCa patients selected from a German multi-center study. Depression and anxiety were assessed with the PHQ-9 and the GAD-7 (cut-off ≥7). We provided physical symptom burden, calculated absolute and relative risk (AR and RR) of depression and anxiety across patient subsets and between patients and the general population (GP) and tested age as a moderator within the relationship of disease-specific symptoms with depression and anxiety.
Among 636 participants, the majority reported disease-specific problems (sexuality: 60%; urination: 52%). AR for depression and anxiety was 23% and 22%, respectively. Significant RR were small, with higher risks of distress in patients who are younger (eg, RR = 1.15; 95%-CI: 1.06-1.26), treated with chemotherapy (RR = 1.46; 95%-CI: 1.09-1.96) or having metastases (RR = 1.30; 95%-CI: 1.02-1.65). Risk of distress was slightly elevated compared to GP (eg, RR = 1.13; 95%-CI: 1.07-1.19). Age moderated the relationship between symptoms and anxiety (B = -0.10, P = .02; B = -0.11, P = .01).
Younger patients, those with metastases or treatment with chemotherapy seem to be at elevated risk for distress and should be closely monitored. Many patients suffer from disease-specific symptom burden, by which younger patients seem to be particularly distressed. Support of coping mechanisms associated with disease-specific symptom burden seems warranted.
为了优化心理肿瘤学护理，需要进行研究以量化困扰程度并确定某些风险群体。在前列腺癌（PCa）患者中，关于抑郁和焦虑的研究结果有限。
我们分析了从一项德国多中心研究中选择的 PCa 患者的数据。使用 PHQ-9 和 GAD-7（临界值≥7）评估抑郁和焦虑。我们提供了身体症状负担，并计算了不同患者亚组和患者与一般人群（GP）之间的抑郁和焦虑的绝对和相对风险（AR 和 RR），并在疾病特异性症状与抑郁和焦虑的关系中测试了年龄作为调节因素。
在 636 名参与者中，大多数报告了疾病特异性问题（性功能：60%；排尿：52%）。抑郁和焦虑的 AR 分别为 23%和 22%。RR 差异显著较小，年龄较小的患者（例如，RR=1.15；95%-CI：1.06-1.26）、接受化疗（RR=1.46；95%-CI：1.09-1.96）或有转移的患者（RR=1.30；95%-CI：1.02-1.65）的焦虑风险较高。与 GP 相比，焦虑风险略有升高（例如，RR=1.13；95%-CI：1.07-1.19）。年龄调节了症状与焦虑之间的关系（B=-0.10，P=0.02；B=-0.11，P=0.01）。
年龄较小、有转移或接受化疗的患者似乎有更高的困扰风险，应密切监测。许多患者患有疾病特异性症状负担，其中年龄较小的患者似乎特别痛苦。似乎需要支持与疾病特异性症状负担相关的应对机制。
