Patterns and predictors of self‐reported clinical diagnosis and treatment for depression in prostate cancer survivors

Abstract

Background Appropriate depression care is a cancer‐care priority. However, many cancer survivors live with undiagnosed and untreated depression. Prostate cancer survivors may be particularly vulnerable, but little is known about their access to depression care. The goal of this study was to describe patterns and predictors of clinical diagnosis and treatment of depression in prostate cancer survivors. Methods Generalized estimating equations were used to evaluate indicators of self‐reported clinical diagnosis and treatment depression as a function of individual‐level characteristics within a longitudinal dataset. The data were from a population‐based cohort of North Carolinian prostate cancer survivors who were enrolled from 2004 to 2007 on the North Carolina‐Louisiana Prostate Cancer Project (N = 1,031), and prospectively followed annually from 2008 to 2011 on the Health Care Access and Prostate Cancer Treatment in North Carolina (N = 805). Results The average rate of self‐reported clinical diagnosis of depression was 44% (95% CI: 39%‐49%), which declined from 60% to 40% between prostate cancer diagnosis and 5‐7 years later. Factors associated with lower odds of self‐reported clinical diagnosis of depression include African‐American race, employment, age at enrollment, low education, infrequent primary care visits, and living with a prostate cancer diagnosis for more than 2 years. The average rate of self‐reported depression treatment was 62% (95% CI: 55%‐69%). Factors associated with lower odds of self‐reported depression treatment included employment and living with a prostate cancer diagnosis for 2 or more years. Conclusion Prostate cancer survivors experience barriers when in need of depression care.

A cross-sectional study on demoralization in prostate cancer patients: the role of masculine self-esteem, depression, and resilience

“…Fervaha et al [ 4 ] reported that risk factors for depression in PCa patients can be classified as both biological (e.g., advanced stage, greater burden of physical symptoms, and older age) and psycho-social (e.g., helplessness, low family support, not being partnered, and a personal history of psychiatric illness). Similarly, Erim et al [ 5 ] found that the most predictive factors for depression were ethnicity (i.e., not being Caucasian), unemployment, low annual income, past depression, comorbidities, treatment decisional regret, and nonadherence to exercise recommendations. Regarding suicidal ideation, Recklitis et al [ 6 ] found that it was significantly associated with employment status, poor physical and emotional functioning, greater symptom burden, higher frequency of significant pain, and depression.…”

Cost-Effectiveness of Providing the Depression Care for People With Cancer Program to Patients With Prostate Cancer in the United States

“…This may be inpatient (1.4%) or outpatient (2 in 3 cases). 7,8,28 Treatment options include antidepressants (eg, Prozac), psychotherapy (eg, cognitive behavioral therapy), or both (ie, combination therapy). Depression treatment promotes remission (from the second month of treatment) and prevents relapse or recurrence.…”

“…1,2 US patients with prostate cancer experience barriers when in need of depression care-for example, from a reluctance to seek mental healthcare, low depression screening rates in primary care clinics (4%), moderate accuracy of unassisted clinical diagnosis of depression (50%), and prospectively declining odds of clinical diagnosis and treatment of depression. [3][4][5][6][7][8] Fulfilling unmet depression care needs is a survivorship priority, 9 and a promising strategy for managing comorbid depression in US patients with prostate cancer is an integrated collaborative care model called the Depression Care for People with Cancer program (DCPC). [10][11][12] DCPC is an intensive, manualized, collaborative care-based multicomponent depression care model that is specifically designed to be integrated with cancer treatment.…”

Study of Antidepressant-Like Effects of Albiflorin and Paeoniflorin Through Metabolomics From the Perspective of Cancer-Related Depression

“…Health departments and cancer commissions in the US and the UK have all called for more attention to be paid to the depression in cancer patients (4). However, because of the lack of awareness among medical personnel and family caregivers, distress in cancer patients is frequently overlooked and under-treated (8). Furthermore, there are few effective pharmacotherapies (9,10).…”