The burden of depression in prostate cancer
Article first published online: 12 AUG 2011
Copyright © 2011 John Wiley & Sons, Ltd.
Volume 21, Issue 12, pages 1338–1345, December 2012
How to Cite
Jayadevappa, R., Malkowicz, S. B., Chhatre, S., Johnson, J. C. and Gallo, J. J. (2012), The burden of depression in prostate cancer. Psycho-Oncology, 21: 1338–1345. doi: 10.1002/pon.2032
- Issue published online: 4 DEC 2012
- Article first published online: 12 AUG 2011
- Manuscript Accepted: 8 JUN 2011
- Manuscript Revised: 5 JUN 2011
- Manuscript Received: 9 MAR 2011
- National Cancer Institute. Grant Numbers: 5RO3CA 121338-02, 5P30AG031043-03, 2K24MH070407-06
- National Institutes of Health
- prostate cancer;
- health resource utilization
We sought to analyze the prevalence and incremental burden of depression among elderly with prostate cancer.
We adopted a retrospective cohort design using the Surveillance, Epidemiology and End Results-Medicare linked database between 1995 and 2003. Patients with prostate cancer diagnosed between 1995 and 1998 were identified and followed retrospectively for 1 year pre-diagnosis and up to 8 years post diagnosis. In this cohort of patients with prostate cancer, depression during treatment phase (1 year after diagnosis of prostate cancer) or in the follow-up phase was identified using the International Classification of Diseases-Ninth Revision depression-related codes. Poisson, general linear (log-link) and Cox regression models were used to determine the association between depression status during treatment and follow-up phases and outcomes–health resource utilization, cost and mortality.
Of the 50,147 patients newly diagnosed with prostate cancer, 4285 (8.54%) had a diagnosis of depression. A diagnosis of depression during treatment phase was associated with higher odds of emergency room visits (odds ratio (OR) = 4.45, 95% CI = 4.13, 4.80), hospitalizations (OR = 3.22, CI = 3.08, 3.37), outpatient visits (OR = 1.71, CI = 1.67, 1.75) and excess risk of death over the course of the follow-up interval (hazard ratio = 2.82, CI = 2.60, 3.06). Health care costs associated with depression remained elevated compared with costs for men without depression, over the course of the follow-up.
Depression during the treatment phase was associated with significant health resource utilization, costs and mortality among men with prostate cancer. These findings emphasize the need to effectively identify and treat depression in the setting of prostate cancer. Copyright © 2011 John Wiley & Sons, Ltd.