Depressive symptoms are found to be potential adverse effects of androgen deprivation therapy in older prostate cancer patients: a 15-month prospective, observational study

To evaluate the association between androgen deprivation therapy (ADT) and depression and to identify the risk factors for depressive symptoms among prostate cancer patients who received ADT.

We conducted a prospective, longitudinal, controlled study and assessed three groups of older patients: the ADT group (men who were presented with maximum androgen block); the radical prostatectomy group (RP) (PCa control group: men who underwent radical prostatectomy without ADT); and the BPH group (men who had benign prostatic hyperplasia). All patients completed the demographic questionnaire at baseline and the Zung Self-Rating Depression Scale (SDS) at pretreatment baseline, 1 month, 6 months, 9 months, 12 months and 15 months.

A total of 146 patients completed the study during the 15-month follow-up. The SDS scores of the three groups showed significant differences at 1 month (p < 0.001), 6 months (p = .009), 9 months (p < 0.001), 12 months (p < 0.001) and 15 months (p < 0.001). At 9 months, 12% of the men in the ADT group, 4.3% in the RP group and 2% in the BPH group showed depressive symptoms, and there were no significant differences (p = 0.095). However, there were significant differences among the three groups relative to the incidence of depressive symptoms at 12 months and 15 months (p < 0.001, p = 0.007, respectively). The analysis of the ADT subgroup indicated that alcohol consumption ( OR = 6.868; p = 0.046; 95% CI, 1.038 - 45.443) and smoking(OR = 13.661; p = 0.013;95% CI:1.722-108.386)increased the risk for developing depressive symptoms.

ADT use does significantly increase the depressive scores and enhance the incidence of depression among PCa patients who received ADT. Smoking and alcohol consumption are associated with depressive symptoms among PCa patients receiving ADT.

Psycho-oncology. 2017 May 04 [Epub ahead of print]

Zhiqiang Zhang, Linlin Yang, Dongdong Xie, Haoqiang Shi, Guangyuan Li, Dexin Yu

Department of Urology, the Second Affiliated Hospital of Anhui Medical University, Anhui, China., Geriatric ward, the Third Affiliated Hospital of Anhui Medical University, Anhui, China., Department of Urology, the First Affiliated Hospital of Anhui Medical University, Anhui, China., Department of Urology, the Fourth Affiliated Hospital of Anhui Medical University, Anhui, China.