A quantitative analysis of the prevalence of clinical depression and anxiety in patients with prostate cancer undergoing active surveillance

Abstract

ObjectiveTo quantitatively determine the prevalence of anxiety and depression in men on active surveillance (AS).DesignCross-sectional questionnaire survey.SettingSecondary care prostate cancer (PCa) clinics across South, Central and Western England.Participants313 men from a total sample of 426 with a histological diagnosis of PCa currently managed with AS were identified from seven UK urology departments. The mean age of respondents was 70 (51–86) years with the majority (76%) being married or in civil partnerships. 94% of responders were of white British ethnicity.Primary outcome measuresThe prevalence of clinically meaningful depression and anxiety as assessed by the Hospital Anxiety and Depression Scale (HADS; score ≥8/21).Secondary outcome measuresPatient demographic data (age, employment, relationship, ethnic and educational status). Each demographic variable was cross-tabulated against patients identified as depressed or anxious to allow for the identification of variables that were significantly associated with depression and anxiety. In order to determine predictors for depression and anxiety among the demographic variables, logistic regression analyses were conducted, with p<0.05 considered as indicating statistical significance.ResultsThe prevalence of clinical anxiety and depression as determined via the HADS (HADS ≥8) was 23% (n=73) and 12.5% (n=39), respectively. Published data from men in the general population of similar age has shown prevalence rates of 8% and 6%, respectively, indicating a twofold increase in depression and a threefold increase in anxiety among AS patients. Our findings also suggest that AS patients experience substantially greater levels of anxiety than patients with PCa treated radically. The only demographic predictor for anxiety or depression was divorce.ConclusionsPatients with PCa managed with AS experienced substantially higher rates of anxiety and depression than that expected in the general population. Strategies to address this are needed to improve the management of this population and their quality of life.

Effects of individual and partner factors on anxiety and depression in Taiwanese prostate cancer patients: A longitudinal study

“…Kohler et al (2014) T A B L E 2 (Continued) cancer patients living with and without partners and that they conducted first-time data collection 1 day before in-hospital radical prostatectomy. Such patients may have experienced intense anxiety because of their marital partnerships (Watts et al, 2015) and their situations (Hinz et al, 2009). The present study also supports the findings of Chen et al (2015) that Taiwanese patients with prostate cancer suffer from high depressive disorders; the reported findings further fill the knowledge gap regarding the prevalence of depression among patients with prostate cancer within 1 year after diagnosis in Taiwan.…”

The long‐term quality of life and information needs of prostate cancer survivors

“…This is important as Watts et al (2015), in a study of 313 men on active surveillance for prostate cancer, reported significantly higher levels of anxiety compared to that found in the general population. Men who underwent surgery and brachytherapy also scored well in this domain; however, men who undertook active surveillance scored poorly (p = 0·019).…”

“…Fear, anxiety, depression, reduced self-esteem and altered body image are recognized by many authors as having a negative effect on men with a diagnosis of prostate cancer (Chien et al, 2013;Hansen et al, 2013;Lassen et al, 2013;Watts et al, 2015). Fear, anxiety, depression, reduced self-esteem and altered body image are recognized by many authors as having a negative effect on men with a diagnosis of prostate cancer (Chien et al, 2013;Hansen et al, 2013;Lassen et al, 2013;Watts et al, 2015).…”

Robot-assisted radical prostatectomy in low- and high-risk prostate cancer patients

“…[20] Another problem for these AS patients is anxiety. Analysis made by Watts et al [21] revealed that these patients have higher rates of anxiety and depression than that expected. Up to 33% of the patients who underwent RP on AS had PSMs.…”