Psychological distress and adjustment to disease in patients before and after radical prostatectomy. Results of a prospective multi-centre study

Abstract

The aim of this prospective multi-centre study was to evaluate the level of psychological distress (PD) and adjustment to disease in patients who underwent radical prostatectomy. Furthermore, the impact of urinary incontinence and erectile dysfunction on PD was assessed. Anxiety, depression and PD were evaluated using the Hospital Anxiety and Depression Scale in 329 prostate cancer patients before surgery as well as 3, 6 and 12 months after surgery. These results were compared with those of a male German general population reference group. Adjustment to disease was assessed using the Perceived Adjustment to Chronic Illness Scale. Patients reported low levels of PD at all points of assessment similar to population norms of age-matched German men. Persistent PD was seen in about 8% of the patients and 20% had PD at least two of the measurement points. Relevant predictors for PD after surgery were urinary symptoms and baseline PD. Adjustment to disease was highest before surgery and had significantly reduced at 3 and 6 months after surgery. In general, men are resilient to the experience of localised prostate cancer and adjust well psychologically after surgery. However, between 8% and 20% of patients could possibly benefit from mental health support.

The association between partner support and psychological distress among prostate cancer survivors in a nationwide study

“…The complexity of dealing with a diagnosis of cancer can challenge this role expectation [39, 40], but also make it less likely that a male cancer survivor will report distress. Studies designed to measure and address distress in prostate cancer survivors have been hindered by reporting issues and by apparent differences between men reporting high distress and men reporting low or no distress [41]. …”

Influence of Depression on Recovery After Major Noncardiac Surgery

“…32 Although the choice of HADS cutoff is still debated, 33 !8 is suggested as the best solution for balancing sensitivity and specificity for the depression scale. 34 Studies using the HADS in the setting of surgery are rare and have used different cutoffs, producing prevalence rates from 7% (cutoff!11) 35 to 32% (cutoff!5). 36 It is important to note that the HADS is not designed to diagnose depression, as the Diagnostic and Statistical Manual (DSM) does, or its cause but to assess depressive symptoms.…”

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

“…Individual factors of anxiety and depression include younger age (Hinz et al, 2009;Vodermaier, Linden, MacKenzie, Greig, & Marshall, 2011), adverse urinary symptoms (Kohler et al, 2014;Punnen et al, 2013), poor bowel function (Segrin, Badger, & Harrington, 2012), poor sexual function (Howlett et al, 2010;Punnen et al, 2013;Roberts, Lepore, Hanlon, & Helgeson, 2010), less problem-focused coping and adaptive emotion-focused coping (Lafaye et al, 2014). Individual factors of anxiety and depression include younger age (Hinz et al, 2009;Vodermaier, Linden, MacKenzie, Greig, & Marshall, 2011), adverse urinary symptoms (Kohler et al, 2014;Punnen et al, 2013), poor bowel function (Segrin, Badger, & Harrington, 2012), poor sexual function (Howlett et al, 2010;Punnen et al, 2013;Roberts, Lepore, Hanlon, & Helgeson, 2010), less problem-focused coping and adaptive emotion-focused coping (Lafaye et al, 2014).…”