Longitudinal screening for depression and anxiety in men with prostate cancer identified additional patients who initially did not present with symptoms, according to results of a study presented at the 2022 ASCO Annual Meeting.
Untreated depression or anxiety has been associated with poorer outcomes. Patients with prostate cancer often experience many phases of disease or treatment spanning years, and androgen deprivation therapy (ADT) has been associated with mood changes and depression.
For this study, 201 men who had a prostate cancer-related clinic visit in the last 6 months were sent the 9-item Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder-7 (GAD-7) screening tools every 60 days via email. Risk factors for developing symptoms of depression or anxiety were evaluated (score of 10 or higher on PHQ-9 or GAD-7, respectively).
Patients had localized (50.7%), metastatic (30.3%), and biochemically recurrent (18.9%) prostate cancer, and 40.8% were receiving ADT. The patients reported a history of depression (22.9%), anxiety (19.9%), and other (9.0%); 19.9% were on antidepressants, 8.5% on anxiolytics, and 2.0% antipsychotic.
Most patients responded to at least 2 screening emails.
At a mean follow-up of 6.5 months, 15.4% screened positive for depression and 4.5% for anxiety. Half of those with positive screening results had negative screening results at the initial evaluation.
The development of symptoms occurred more frequently during a period of disease or treatment transition (P =.003) and when starting or continuing ADT (P =.002).
Screening positive was associated with a history of psychiatric disorder (odds ratio [OR], 6.3; P =.001), ADT (OR, 3.8; P =.005), and lower income (OR, 1.7; P =.002).
These data reinforced current recommendations that symptoms of depression and anxiety should be longitudinally screened, as half of patients with prostate cancer developed depression or anxiety during their disease course.
Wong RL, Cheng HH, Fann JR, et al. Longitudinal screening for depression and anxiety in prostate cancer (PC) and association with disease and treatment factors. J Clin Oncol. 2022;40(suppl 16; abstr 5023).