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

A quantitative analysis of the prevalence of clinical depression and anxiety in patients with prostate cancer undergoing active surveillance
A quantitative analysis of the prevalence of clinical depression and anxiety in patients with prostate cancer undergoing active surveillance
Objective: To quantitatively determine the prevalence of anxiety and depression in men on active surveillance (AS).

Design: Cross-sectional questionnaire survey.

Setting: Secondary care prostate cancer (PCa) clinics across South, Central and Western England.

Participants: 313 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 measures: The prevalence of clinically meaningful depression and anxiety as assessed by the Hospital Anxiety and Depression Scale (HADS; score ?8/21).

Secondary outcome measures: Patient 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.

Results: The 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.

Conclusions: Patients 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.
1-8
Watts, Sam
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Leydon, Geraldine
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Eyles, Caroline
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Moore, Caroline
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Richardson, Alison
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Birch, Brian
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Prescott, Philip
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Powell, Catrin
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Lewith, George
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Watts, Sam
13b4d124-99cb-42ab-bd81-43415974aec0
Leydon, Geraldine
c5cdaff5-0fa1-4d38-b575-b97c2892ec40
Eyles, Caroline
f8518cbb-669f-4cf6-bacb-4a174e385483
Moore, Caroline
d82b5338-7667-4cab-a308-0e09e5306959
Richardson, Alison
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Birch, Brian
536ee8d2-9cf9-4412-a29b-d2267fa9d765
Prescott, Philip
cf0adfdd-989b-4f15-9e60-ef85eed817b2
Powell, Catrin
a0847760-6968-4715-96c4-b38e38e2e415
Lewith, George
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Watts, Sam, Leydon, Geraldine, Eyles, Caroline, Moore, Caroline, Richardson, Alison, Birch, Brian, Prescott, Philip, Powell, Catrin and Lewith, George (2015) A quantitative analysis of the prevalence of clinical depression and anxiety in patients with prostate cancer undergoing active surveillance. BMJ Open, 5 (5), 1-8. (doi:10.1136/bmjopen-2014-006674). (PMID:26002689)

Record type: Article

Abstract

Objective: To quantitatively determine the prevalence of anxiety and depression in men on active surveillance (AS).

Design: Cross-sectional questionnaire survey.

Setting: Secondary care prostate cancer (PCa) clinics across South, Central and Western England.

Participants: 313 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 measures: The prevalence of clinically meaningful depression and anxiety as assessed by the Hospital Anxiety and Depression Scale (HADS; score ?8/21).

Secondary outcome measures: Patient 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.

Results: The 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.

Conclusions: Patients 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.

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More information

Accepted/In Press date: 18 March 2015
e-pub ahead of print date: 22 May 2015
Published date: 18 December 2015
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 385328
URI: http://eprints.soton.ac.uk/id/eprint/385328
PURE UUID: 80ff5f12-708d-4d64-ab65-88a8430e313e
ORCID for Geraldine Leydon: ORCID iD orcid.org/0000-0001-5986-3300
ORCID for Alison Richardson: ORCID iD orcid.org/0000-0003-3127-5755

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Date deposited: 19 Jan 2016 09:33
Last modified: 15 Mar 2024 03:34

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Contributors

Author: Sam Watts
Author: Caroline Eyles
Author: Caroline Moore
Author: Brian Birch
Author: Philip Prescott
Author: Catrin Powell
Author: George Lewith

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