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Men with prostate cancer who underwent androgen deprivation therapy with definitive radiotherapy had an increased risk of depression and use of outpatient psychiatric services compared to men who received radiation alone. , according to the results of the study published in Cancer.
This finding may support evidence for the long-term risks of ADD for psychiatric health in the treatment of prostate cancer, the researchers said.
"There is conflicting evidence on the badociation of ADT with clinical depression. Although some studies have reported an badociation between ADD and depression, others have Rishi Deka, PhD, Postdoctoral researcher in the Department of Radiation Oncology and Applied Sciences at the University of California San Diego School of Medicine, written by his colleagues. "This inconsistency is probably due to the methodological limitations that existed in many of these studies. This indicates a lack of appropriate control groups, small sample sizes, insufficient power, and the use of cross-sectional study plans. In addition, these studies badyzed very heterogeneous populations, including patients with localized metastatic disease, curative and palliative treatment and ADT treatment in initial or recurrent situation. "
In the retrospective, In an observational cohort study, Deka and colleagues identified 39,965 veterans (median age: 66.8 years, 68.6% white) who had been diagnosed with prostate cancer in the system. US Department of Veterans Affairs health care between January 1, 2001 and October 31, 2015. All men received definitive radiotherapy and 14,843 of them also started TDA in the 39 year after diagnosis of prostate cancer (mean duration, 243 days, interquartile range, 90-570).
Men who had an ADD were more likely to be older, non-whites, low-income regions and South or Northeast than men who received only radiation therapy.
They also had higher Gleason scores, higher clinical T and PSA levels, and higher rates of antidepressant and alcohol and substance abuse compared to non-ADT users.
The new development of depression, from the date of the veteran's diagnosis of prostate cancer to his last medical consultation or at the end of the study period, was the primary endpoint of the study. Use of external psychiatric services The use of hospital psychiatric services and suicide served as secondary endpoints.
The researchers followed all men for a median of 6.8 years and 9,341 of them for at least 10 years.
During follow-up, 934 men received a new diagnosis of depression, 7,825 used external psychiatric services, 358 used psychiatric hospital services and 54 committed suicide.
At age 10, researchers found a cumulative incidence of 3.5% for depression (349 events for ADD users vs. 313 events for non-ADT users) and 27.5% for clinical use. external (4,429 events against 3,260; P <0.05 for both). The cumulative incidence of psychiatric use of hospitalized patients at age 10 was 1.2%, but the difference between cohorts was not statistically significant.
A Multivariate Risk Regression Model in Competition Revealed Correlations Between ADD and the Beginning of Depression (HR Subdistribution [SHR] = 1.5; 95% CI, 1.32-1.71) and use of ambulatory psychiatric services (OR = 1.21, 95% CI, 1.16-1.27). Other predictors of outpatient psychiatric use include a higher Charlson Comorbidity Index, an African-American race, a serotonin reuptake inhibitor, serotonin modulating or tricyclic antidepressants, atypical antidepressants, addictions and cigarettes.
ADD did not appear to be badociated with psychiatric use in hospitals (OR = 1.21, 95% CI, 0.98-1.51) or suicide (OR = 0.93, 95% CI, 0.53). -1.62).
The researchers acknowledged the limitations of the study, noting that results were generally generalized to patients treated with radiotherapy, that the study population did not include patients with recurrent or metastatic disease and that the determination of depression was based on the ICD-9 codes.
ASCO provides guidelines for the screening, badessment and treatment of depression in cancer patients, which clinicians can use, along with other tools, to badess patients during diagnosis and regularly during treatment. Laura C. Polacek, BA, and Christian J. Nelson, PhD, of the Department of Psychiatry and Behavioral Services at the Memorial Sloan Kettering Cancer Center, wrote in a related editorial.
"While research on depression, aging, and cancer continues, there is no doubt that the phenomenology and diagnosis of depression in cancer patients, particularly those with cancer prostate, are complex, "wrote Polacek and Nelson. "Like research like Deka's [and colleagues] continues to provide strong support for the cause-and-effect relationship between ADD use and depression in prostate cancer patients, it is imperative that clinicians be vigilant in screening and treatment depression in this population. "- by Jennifer Byrne
Disclosures: Researchers and authors do not report any relevant financial information.
Men with prostate cancer who underwent androgen deprivation therapy with definitive radiotherapy had an increased risk of depression and use of outpatient psychiatric services compared to men who received radiation alone. , according to the results of the study published in Cancer.
This finding may support evidence for the long-term risks of ADD for psychiatric health in the treatment of prostate cancer, the researchers said.
"There is conflicting evidence on the badociation of ADT with clinical depression. Although some studies have reported an badociation between ADD and depression, others have Rishi Deka, PhD, Postdoctoral researcher in the Department of Radiation Oncology and Applied Sciences at the University of California San Diego School of Medicine, written by his colleagues. "This inconsistency is probably due to the methodological limitations that existed in many of these studies. This indicates a lack of appropriate control groups, small sample sizes, insufficient power, and the use of cross-sectional study plans. In addition, these studies badyzed very heterogeneous populations, including patients with localized metastatic disease, curative and palliative treatment and ADT treatment in initial or recurrent situation. "
In the retrospective, In an observational cohort study, Deka and colleagues identified 39,965 veterans (median age: 66.8 years, 68.6% white) who had been diagnosed with prostate cancer in the system. US Department of Veterans Affairs health care between January 1, 2001 and October 31, 2015. All men received definitive radiotherapy and 14,843 of them also started TDA in the 39 year after diagnosis of prostate cancer (mean duration, 243 days, interquartile range, 90-570).
Men who had an ADD were more likely to be older, non-whites, low-income regions and South or Northeast than men who received only radiation therapy.
They also had higher Gleason scores, higher clinical T and PSA levels, and higher rates of antidepressant and alcohol and substance abuse compared to non-ADT users.
The new development of depression, from the date of the veteran's diagnosis of prostate cancer to his last medical consultation or at the end of the study period, was the primary endpoint of the study. Use of external psychiatric services The use of hospital psychiatric services and suicide served as secondary endpoints.
The researchers followed all men for a median of 6.8 years and 9,341 of them for at least 10 years.
During follow-up, 934 men received a new diagnosis of depression, 7,825 used external psychiatric services, 358 used psychiatric hospital services and 54 committed suicide.
At age 10, researchers found a cumulative incidence of 3.5% for depression (349 events for ADD users vs. 313 events for non-ADT users) and 27.5% for clinical use. external (4,429 events against 3,260; P <0.05 for both). The cumulative incidence of psychiatric use of hospitalized patients at age 10 was 1.2%, but the difference between cohorts was not statistically significant.
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A Multivariate Risk Regression Model in Competition Revealed Correlations Between ADD and the Beginning of Depression (HR Subdistribution [SHR] = 1.5; 95% CI, 1.32-1.71) and use of ambulatory psychiatric services (OR = 1.21, 95% CI, 1.16-1.27). Other predictors of outpatient psychiatric use include a higher Charlson Comorbidity Index, an African-American race, a serotonin reuptake inhibitor, serotonin modulating or tricyclic antidepressants, atypical antidepressants, addictions and cigarettes.
ADD did not appear to be badociated with psychiatric use in hospitals (OR = 1.21, 95% CI, 0.98-1.51) or suicide (OR = 0.93, 95% CI, 0.53). -1.62).
The researchers acknowledged the limitations of the study, noting that results were generally generalized to patients treated with radiotherapy, that the study population did not include patients with recurrent or metastatic disease and that the determination of depression was based on the ICD-9 codes.
ASCO provides guidelines for the screening, badessment and treatment of depression in cancer patients, which clinicians can use, along with other tools, to badess patients during diagnosis and regularly during treatment. Laura C. Polacek, BA, and Christian J. Nelson, PhD, of the Department of Psychiatry and Behavioral Services at the Memorial Sloan Kettering Cancer Center, wrote in a related editorial.
"While research on depression, aging, and cancer continues, there is no doubt that the phenomenology and diagnosis of depression in cancer patients, particularly those with cancer prostate, are complex, "wrote Polacek and Nelson. "Like research like Deka's [and colleagues] continues to provide strong support for the cause-and-effect relationship between ADD use and depression in prostate cancer patients, it is imperative that clinicians be vigilant in screening and treatment depression in this population. "- by Jennifer Byrne
Disclosures: Researchers and authors do not report any relevant financial information.
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