Psychiatric treatment in men with prostate cancer--results from a Nation-wide, population-based cohort study from PCBaSe Sweden |
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Authors: | Bill-Axelson Anna Garmo Hans Nyberg Ullakarin Lambe Mats Bratt Ola Stattin Pär Adolfsson Jan Steineck Gunnar |
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Institution: | a Department of Urology, University Hospital, Uppsala, Sweden b Department of Clinical Cancer Epidemiology, Karolinska Institutet, Stockholm, Sweden c Regional Oncologic Center, University Hospital, Uppsala, Sweden d King’s College London, School of Medicine, Division of Cancer Studies, London, UK e Department of Clinical Neuroscience, Section of Psychiatry St. Göran, Karolinska Institutet, Stockholm, Sweden f Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden g Department of Urology, Hospital of Helsingborg, Lund University, Helsingborg, Sweden h Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden i Oncological Center, CLINTEC Department, Karolinska Institutet, Stockholm, Sweden j Division of Clinical Cancer Epidemiology, The Sahlgrenska Academy, Gothenburg, Sweden |
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Abstract: | AimTo explore whether the self-reported psychological distress among men with prostate cancer was to the extent that it required psychiatric treatment.MethodsPCBaSe Sweden, a merged database based on the National Prostate Cancer Register including 97% of all prostate cancers registered as well as age-matched controls. We calculated relative risks and 95% confidence intervals to compare risks of psychiatric treatment due to depression, anxiety, and post-traumatic stress disorder controlling for age and socio-economic factors. We used odds ratios to compare use or no use of antidepressants.FindingsIn total 72,613 men with prostate cancer and 217,839 men without prostate cancer were included for analyses. Psychiatric hospitalisation due to depression, anxiety and post-traumatic stress disorder were significantly increased (RR 1.29, (95% CI 1.14-1.45), RR 1.42 (95% CI 1.12-1.80) and RR 1.61 (95% CI 1.16-2.24), respectively). However, hospitalisations due to anxiety were only increased in men with more advanced tumours RR 2.28 (95% CI 1.45-3.57). The use of antidepressants was increased for all men with prostate cancer RR 1.65 (95% CI 1.54-1.77) and treatment strategies RR 1.93 (95% CI 1.75-2.13).InterpretationMen diagnosed with prostate cancer had increased risk of psychiatric treatment for depression, post-traumatic stress disorder and use of antidepressants regardless of risk group and treatment strategy compared to age-matched controls, whilst more advanced prostate cancer was associated with severe anxiety disorders. |
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Keywords: | Prostate cancer Depression Anxiety post-traumatic stress disorder Androgen deprivation therapy Cohort study Population-based |
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