Impact of androgen deprivation therapy on depressive symptoms in men with nonmetastatic prostate cancer

Authors

  • Narhari Timilshina MPH,

    1. Department of Medicine, University Health Network, Toronto, Ontario, Canada
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  • Henriette Breunis CRA,

    1. Department of Medicine, University Health Network, Toronto, Ontario, Canada
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  • Shabbir Alibhai MD, MSc

    Corresponding author
    1. Department of Medicine, University Health Network, Toronto, Ontario, Canada
    2. Geriatric Program, Toronto Rehabilitation Institute, Toronto, Ontario, Canada
    3. Department of Medicine, University of Toronto, Toronto, Ontario, Canada
    4. Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
    • University Health Network, Room EN14-214, 200 Elizabeth Street, Toronto M5G 2C4, Canada
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    • Fax: (416) 595-5826


Abstract

BACKGROUND:

Up to 50% of prostate cancer (PC) patients receive androgen deprivation therapy (ADT), often for several years. Although depression has been reported after a diagnosis of PC, whether ADT leads to or worsens depression is not clear.

METHODS:

Three groups were assembled: ADT users (men initiating continuous ADT), PC controls (PC patients who were not on ADT), and healthy controls. All 3 cohorts were matched on age, education, and physical function, and none had metastases. Depression was measured at study entry and again at 3, 6, and 12 months using the 15-item Geriatric Depression Scale (GDS). Our primary outcomes were worsening depressive symptoms and incident depression (defined as a GDS score ≥5), analyzed using adjusted linear regression and logistic regression, respectively.

RESULTS:

Of the 257 participants (mean age, 69.1 years), baseline characteristics including GDS score and prior depression were similar across cohorts. In adjusted analyses of initially nondepressed patients, ADT use was not a significant predictor of change in GDS score at 3 months (P = .42), 6 months (P = .25), or 12 months (P = 0.19). Among ADT users, 8%-9% of participants developed incident depression compared with 0%-4% among PC controls and 4%-6% among healthy controls over 3-12 months (P>.05 at all time points). In a separate analysis of patients with depression at baseline, there was no effect of ADT on depressive symptoms at 3, 6, or 12 months (P = .11, .74, and .12, respectively).

CONCLUSION:

Twelve months of ADT use were not associated with worsening depressive symptoms among nondepressed or depressed patients with nonmetastatic PC. Cancer 2012;. © 2011 American Cancer Society.

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