The Association of A Number of Risk Factors With Depression in Patients With Prostate Cancer Undergoing Androgen Deprivation Therapy

Chang Hee Kim, Kwang Teack Kim, Jin Kyu Oh, Kyung Jin Chung, Tae Beom Kim, Han Jung, Sang Jin Yoon, Khae Hawn Kim

Abstract


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Purpose: To identify factors affecting depressive symptoms in patients undergoing androgen-deprivation therapy (ADT) to treat prostate cancer.
Materials and Methods: The patients with prostate cancer visiting the psychiatry department without referral because of depressive symptoms while undergoing ADT participated. To assess depressive symptoms, the Beck Depression Inventory (BDI) was used. To identify the risk factors affecting depressive symptoms, univariate regression and multiple linear regression analyses were implemented.
Results: The mean (± SD) age, age when initiating ADT, duration of ADT, serum testosterone level and BDI scores of participants (n = 45) were 73.9 ± 7.9 years, 72 ± 8.5 years, 33 ± 31.6 months, 214.9 ± 219.5 ng/dL and 18 ± 13.5 points. The androgen dependent and independent were 26 and 9 patients. Eight of these androgen-independent patients underwent concurrent chemotherapy. Twenty-one patients were treated with bicalutamide and 24 with leuprolide. Of the clinical variables affecting BDI scores, the type of ADT drug (P < 0.001), serum testosterone level (P = 0.003), and age at diagnosis (P < 0.001) were significant.
Conclusion: Efforts to diagnose and treat depression appropriately, especially if depressive symptoms change in patients undergoing ADT to treat prostate cancer who are using an LHRH agonist (leuprolide), have low testosterone
level, or are older at the age when initiating ADT.


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References


Howlader N, Noone A, Krapcho M, et al. SEER Cancer Statistics Review, 1975–2009 (Vintage 2009 Populations), National Cancer Institute. Bethesda, MD. Based on November 2011 SEER data submission, posted to the SEER web site, April 2012; 2012.

Smith MR. Androgen deprivation therapy for prostate cancer: new concepts and concerns. Curr Opin in Endocrinol. 2007;14:247.

Barrass B, Thurairaja R, Persad R. More should be done to prevent the harmful effects of long‐term androgen ablation therapy in prostate cancer. BJU Int. 2004;93:1175-6.

Choi H, Chung H, Park JY, Lee JG, Bae JH. The Influence of Androgen Deprivation Therapy on Prostate Size and Voiding Symptoms in Prostate Cancer Patients in Korea. Int Neurourol J. 2016;20:342.

Gooren LJ. Clinical review: Ethical and medical considerations of androgen deprivation treatment of sex offenders. J Clin Endocrinol Metab. 2011;96:3628-37.

Casey RG, Corcoran NM, Goldenberg SL. Quality of life issues in men undergoing androgen deprivation therapy: a review. Asian J Androl. 2012;14:226-31.

Rosenblatt DE, Mellow A. Depression during hormonal treatment of prostate cancer. J Am Board Fam Pract. 1995;8:317-20.

Osborn RL, Demoncada AC, Feuerstein M. Psychosocial interventions for depression, anxiety, and quality of life in cancer survivors: meta-analyses. Int J Psychiat Med. 2006;36:13-34.

Fallowfield L, Ratcliffe D, Jenkins V, Saul J. Psychiatric morbidity and its recognition by doctors in patients with cancer. Brit J Cancer. 2001;84:1011.

Passik SD, Dugan W, McDonald MV, Rosenfeld B, Theobald DE, Edgerton S. Oncologists' recognition of depression in their patients with cancer. J Clin Oncol. 1998;16:1594-600.

Kathol RG, Mutgi A, Williams J, Clamon G, Noyes R, Jr. Diagnosis of major depression in cancer patients according to four sets of criteria. Am J Psychiatry. 1990;147:1021-4.

Lee E-H, Lee S-J, Hwang S-T, Hong S-H, Kim J-H. Reliability and Validity of the Beck Depression Inventory-II among Korean Adolescents. Psychiat invest. 2017;14:30-6.

Antonarakis ES, Kibel AS, Evan YY, et al. Sequencing of sipuleucel-t and androgen deprivation therapy in men with hormonesensitive

biochemically recurrent prostate cancer: A phase ii randomized trial. Clin

Cancer Res. 2017;23:2451-9. 14. Barrett-Connor E, von Mühlen DG, Kritz-Silverstein D. Bioavailable testosterone and depressed mood in older men: the Rancho Bernardo Study. The Journal of Clinical Endocrinol Metab. 1999;84:573-7.

Pirl WF, Siegel GI, Goode MJ, Smith MR. Depression in men receiving androgen deprivation therapy for prostate cancer: a pilot study. Psycho‐Oncology. 2002;11:518-23.

Goa KL, Spencer CM. Bicalutamide in advanced prostate cancer. Drug Aging. 1998;12:401-22.

Furr B, Tucker H. The preclinical development of bicalutamide: pharmacodynamics and mechanism of action. Urology. 1996;47:13-25.

Meyers B, D'agostino A, Walker J, Kritzer M. Gonadectomy and hormone replacement exert region-and enzyme isoform-specific effects on monoamine oxidase and catechol-O-methyltransferase activity in prefrontal cortex and neostriatum of adult male rats.

Neuroscience. 2010;165:850-62.

Aragon-Ching JB, Williams KM, Gulley JL. Impact of androgen-deprivation therapy on the immune system: implications for combination

therapy of prostate cancer. Front Biosci. 2007;12:71.

Amore M, Innamorati M, Costi S, Sher L, Girardi P, Pompili M. Partial androgen deficiency, depression, and testosterone supplementation in aging men. Int J Endocrinol. 2012;2012.

Lee M, Jim HS, Fishman M, et al. Depressive symptomatology in men receiving androgen deprivation therapy for prostate cancer: A controlled comparison. Psycho‐Oncol. 2015;24:472-7.

Shin M-S, Chung KJ, Ko I-G, et al. Effects of surgical and chemical castration on spatial learning ability in relation to cell proliferation

and apoptosis in hippocampus. Int Urol Nephrol. 2016;48:517-27.

Reynolds K, Pietrzak RH, El-Gabalawy R, Mackenzie CS, Sareen J. Prevalence of psychiatric disorders in US older adults: findings from a nationally representative survey. World Psychiatry. 2015;14:74-81.

Murphy E. The prognosis of depression in old age. Brit J Psychiatry. 1983;142:111-9.

Alexopoulos GS, Meyers BS, Young RC, et al. Recovery in geriatric depression. Arch Gen Psychiatry. 1996;53:305-12.

Reynolds CF, Frank E, Dew MA, et al. Treatment of 70+-year-olds with recurrent major depression: excellent short-term but brittle long-term response. Am J Geriatric Psychiatry. 2000;7:64-9.

Beekman AT, Geerlings SW, Deeg DJ, et al. The natural history of late-life depression: a 6-year prospective study in the community. Arch Gen Psychiatry. 2002;59:605-11.

Charney DS, Reynolds CF, Lewis L, et al. Depression and Bipolar Support Alliance consensus statement on the unmet needs in

diagnosis and treatment of mood disorders in late life. Arch Gen Psychiatry. 2003;60:664-72.

Roose SP, Sackeim HA, Krishnan KRR, et al. Antidepressant pharmacotherapy in the treatment of depression in the very old: a randomized, placebo-controlled trial. Am J Psychiatry. 2004;161:2050-9.

Roose SP, Sackeim HA, Krishnan KR, et al. Antidepressant pharmacotherapy in the treatment of depression in the very old: a

randomized, placebo-controlled trial. Am J Psychiatry. 2004;161:2050-9.




DOI: http://dx.doi.org/10.22037/uj.v0i0.4138


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