The role of Melancholia in prostate cancer patients' depression

Abstract

BackgroundAlthough it is well established that prostate cancer (PCa) patients are more likely to experience clinical depression than their age-matched non-prostate cancer peers, and that such depression can have negative effects upon survival, little is known about the underlying nature of the depressive symptomatology that these men experience. In particular, the incidence of melancholic symptoms of depression, which are signs of increased risk of suicide and resistance to treatment, has not previously been reported in PCa patients. The present study aimed to measure the incidence and nature of Melancholia in PCa depression.MethodA sample of 507 PCa patients in Queensland, Australia, completed anonymous and confidential questionnaires about their background, treatment status, and depression. Data were analysed to select depressive symptoms that were part of the definition of Melancholia vs those which were not. Regression was used to determine the links between Melancholia and overall depressive status, and factor analysis revealed the underlying components of Melancholia, which were mapped over time since diagnosis for 3 years.ResultsPsychometric data were satisfactory. Melancholia significantly predicted depressive status for the most depressed subset of patients, but not for the total sample. Melancholia was factored into its components of Anhedonia and Agitation, and the first of these was more powerful in predicting Melancholia. Variability over the 3 years following diagnosis was noted for each of these two components of Melancholia.ConclusionsThe strong presence of Melancholia in the depressive symptomatology of this sample of PCa patients suggests that some forms of treatment for depression may be more likely to succeed than others. The dominance of Anhedonia and Agitation over other symptoms of Melancholia also holds implications for treatment options when assisting these men to cope with their depression.

Variability Over Time-Since- Diagnosis in the Protective Effect of Psychological Resilience Against Depression in Australian Prostate Cancer Patients

“…A total of 425 PCa patients from treatment centers in two states of Australia responded to a posted invitation to participate in a study "about how you feel." This represents a 56.7% response rate, which is commensurate with previous postal surveys carried out with this population (Sharpley, Bitsika, & Christie, 2010;Sharpley, Bitsika, & Christie, 2011a, 2011b. All participants had PCa limited to the primary site and regional draining lymph nodes using conventional staging investigations.…”

“…For example, patients' demographic characteristics such as the availability of family and/or partner support (Carli et al, 2011) and educational, social, and financial standing (O'Hara et al, 2012;Schoevers, Beekman, Deeg, Jonker, & Tilburg, 2003;Vergun, 2012) have been reported to help buffer against depression (Slotsky et al, 1991). However, these background factors do not predict as much of the variance in depression scores as some behavioral or attitudinal factors that equip people who hold them to cope effectively with stress (e.g., Bitsika, Sharpley, Aroutzidis, & Smith, 2011;Sharpley, Bitsika, & Christie, 2011a, 2011bvon Ammon Cavanagh, Furlanetto, Creech, & Powell, 2001). One of those behavioral/ attitudinal factors that has received a good deal of attention recently in various settings and populations is psychological resilience (Fredrickson, Tugade, Waugh, & Larkin, 2003).…”

Variability in Depressive Symptoms of Cognitive Deficit and Cognitive Bias During the First 2 Years After Diagnosis in Australian Men With Prostate Cancer

“…A total of 394 complete and usable questionnaires were collected from a survey of patients with PCa in Brisbane, Australia, who had received their diagnosis of PCa within 25 months of the date of the survey. This response rate is 51%, and is similar to those in several previous survey studies of this population (Sharpley, Bitsika, & Christie, 2012;Sharpley, Bitsika, & Christie, 2013;Sharpley & Christie, 2007). All participants had cancers limited to the primary site and regional draining lymph nodes using conventional staging investigations.…”

Total depression and subtypes in prostate cancer survivors 10 years after treatment

“…These subtypes of depression have different neurobiological pathways, arguing for specific treatment choices for different depression subtypes (Sharpley & Bitsika, 2013). Previous studies have reported on the prevalence of various depression symptom profiles/subtypes in general community samples (Sutin et al, 2013) as well as among PCa patients (Sharpley, Bitsika, & Christie, 2012, 2013a, including those undergoing AST (Sharpley, Christie, Bitsika, & Miller, 2016). This perspective follows the call for "personalised medicine" approaches to diagnosis and treatment of depression (Insel, 2013) as a way of better matching diagnostic profiles to specific treatment options for more effective outcomes.…”