Fervaha Gagan, Izard Jason P, Tripp Dean A, Aghel Nazanin, Shayegan Bobby, Klotz Laurence, Niazi Tamim, Fradet Vincent, Taussky Daniel, Lavallée Luke T, Hamilton Robert J, Brown Ian, Chin Joseph, Gopaul Darin, Violette Philippe D, Davis Margot K, Karampatos Sarah, Pinthus Jehonathan H, Leong Darryl P, Siemens D Robert
School of Medicine, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada.
Department of Urology, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada.
Can Urol Assoc J. 2021 Jun;15(6):181-186. doi: 10.5489/cuaj.6912.
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.
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.
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.
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.
在所有癌症部位和阶段中，前列腺癌的五年中位生存率是最高的之一，这凸显了诊断和治疗后对生存问题的重要关注。在本研究中，我们试图评估一个大型、多中心、当代前瞻性收集的前列腺癌男性样本中抑郁症的患病率及预测因素。
本研究数据取自参与“根治性前列腺癌（RADICAL PC）研究”的男性的基线访视。招募新诊断为前列腺癌的男性或首次开始接受前列腺癌雄激素剥夺治疗的患者。使用患者健康问卷（PHQ-9）的九项版本评估抑郁症状。为评估与抑郁症相关的因素，构建了一个多变量逻辑回归模型，包括生物学、心理学和社会预测变量。
分析了2445例患者的数据。其中，201例（8.2%）认可存在具有临床意义的抑郁症。年龄较小（每降低10岁，比值比[OR]为1.38，95%置信区间[CI]为1.16 - 1.60）、当前吸烟者（OR为2.77，95%CI为1.66 - 4.58）、既往饮酒者（OR为2.63，95%CI为1.33 - 5.20）、身体状况较差（OR为5.01，95%CI为3.49 - 7.20）、既往有抑郁症或焦虑症临床诊断（OR为3.64，95%CI为2.42 - 5.48）以及患有高危前列腺癌（OR为1.49，95%CI为1.05 - 2.12）均为抑郁症的独立危险因素。
具有临床意义的抑郁症在前列腺癌男性中很常见。抑郁症风险与一系列生物心理社会变量相关。临床医生应警惕对那些健康社会决定因素差、伴有残疾和晚期疾病的患者进行抑郁症筛查。
