The prevalence and predictors of psychological distress in patients with early localized prostate cancer

Abstract

Objective To determine the level of psychopathology, traumatic distress and quality of life in men with newly diagnosed clinically localized prostate cancer, the effect on these of a consultation in a combinedspecialist early-prostate clinic, and predictors of psychopathology. Patients and methods Eighty-eight patients were recruited from the combined clinic; they completed a battery of questionnaires including the Hospital Anxiety and Depression Scale (HADS), the revised Impact of Event Scale (IES) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, before their first appointment. Two weeks later they completed the HADS, IES and a patient-satisfaction survey. Results The overall level of psychopathology varied among the questionnaires used, from 0% on the HADS depression scale, 8% on the HADS anxiety scale and 14% on the IES. Anxiety and traumatic stress symptoms were commoner than depressive symptoms. The quality-of-life scores showed a relatively good level of functioning. Pre-morbid factors and disease status did not predict psychological distress. Younger age was mildly predictive of poorer psychological functioning. Anxiety symptoms reduced slightly after a joint clinic appointment, whereas depressive symptoms showed a slight increase. Conclusion This study suggests that men with early localized prostate cancer have low levels of psychopathology overall. However, some men experience distressing psychological symptoms and it is important that future research is conducted to help develop clear guidelines on the optimal methods of detecting and managing men with prostate cancer who have mental health difficulties.

“I wish I’d told them”: A qualitative study examining the unmet psychosexual needs of prostate cancer patients during follow-up after treatment

“…However, the data presented here show that the psychological consequences of the loss of sexual function may only manifest years after treatment when the imminent threat to survival passes [6,53]. These data have important implications for the delivery of psychosexual support during follow-up, as current recommendations suggest that assessment of psychosexual needs should be targeted around the period close to diagnosis [54] and in the early months after treatment [9,55,56]. This study suggests that re-evaluations of men's psychosexual needs after treatment, regardless of perceived stability of disease, might improve the experience of follow-up care for some.…”

The measurement of psychological distress in men being investigated for the presence of prostate cancer

“…These levels and prevalence of both anxiety and depression are similar to population norms for UK men, not matched for age, 19 as well as to other reports of PSA screening 4,11 and from men with a diagnosis of early prostate cancer. 5 However, a recent review of the validity of the HADS stated that an optimal balance between sensitivity and specificity (0.80 each) for both HADS-A and HADS-D could be achieved by using a cut-off score of 8 þ . 20 Table 1 shows that the prevalence of anxiety and depression is much higher at this level, and this is comparable to reports that also consider this threshold, 5 as well as those that use other instruments to measure psychological distress in men with prostate cancer.…”

“…There is a high incidence of psychiatric disturbance reported in women who were recently diagnosed with breast cancer. 1 There have been conflicting reports however, with regard to the prevalence of mental health disturbance in men being investigated and treated for prostate cancer; with some studies reporting a high (50-64%) prevalence of anxiety, 2,3 whereas others report low levels in men being investigated 4 or treated for early localized prostate cancer 5 that are no different from those of a matched normal population. In addition, other reports suggest that men with advanced prostate cancer had significantly greater psychological distress as compared to those with early stage disease.…”

“…A number of validated questionnaires have been used in the assessment of psychological distress in men being investigated and treated for prostate cancer, such as the Hospital Anxiety and Depression Scale (HADS), 5,9 Impact of Event Scale, 5 General Health Questionnaire (GHQ-30), 5 State-Trait Anxiety Inventory (STAI), 11 Visual Analogue Scale (VAS) 3,12 and the prostate cancer-specific Memorial Anxiety Scale for Prostate Cancer. 13 We chose the HADS to fulfil the first two objectives for its simplicity and because it is well-validated in a number of cancers.…”

Psychological aspects of prostate cancer: a clinical review

“…8 Studies have shown that at any given time 20 --60% of patients with prostate cancer may suffer from anxiety in general. 9 PSA testing is associated with a significant amount of anxiety in prostate cancer patients. A blood test to measure PSA is considered the most effective test currently available for the early detection of prostate cancer, but this effectiveness has also been questioned due to risks of false positives and false negatives.…”