Christian J Nelson1, John P Mulhall, Andrew J Roth. 1. Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, 641 Lexington Ave, New York, NY 10021, USA. nelsonc@mskcc.org
Abstract
INTRODUCTION: The relationship between erectile dysfunction (ED) and depressive symptoms is well established. However, this relationship is not well explored in men with prostate cancer. Limited data suggest men with prostate cancer may experience less ED bother than men with ED who do not have prostate cancer, implying that ED and depressive symptoms may not be associated in men with prostate cancer. AIM: To determine if ED is associated with depressive symptoms in men with prostate cancer. MAIN OUTCOME MEASURES: Assessments of quality-of-life (The Functional Assessment of Cancer Therapy [FACT-P]), anxiety/depression (Hospital Anxiety and Depression Scale [HADS]), and erectile function. Erectile function was measured with one question from the FACT-P similar to that used by the Massachusetts Male Aging Study. METHODS: Men with prostate cancer, and naïve of hormone treatment, completed the study questionnaires at a single time point. RESULTS: The average age of the 339 men was 67±10 years. The average time since diagnosis was 3.9±3 years. When answering the question, "I am able to have and maintain an erection" on a 1 to 5 scale (5 representing the best function), the mean score was 2 indicating "a little bit." On univariate analysis, erectile function and depression were associated, r=-0.12, P<0.05. Other variables associated with depression were marital status, r=0.11, P<0.05; anxiety scores, r=0.56, P<0.01; and social support, r=-0.42, P<0.01. On multivariate analysis, erectile function remained a significant predictor of depression, beta=-0.10, P<0.05. CONCLUSIONS: Erectile function was associated with depressive symptoms in both univariate and multivariate analysis, indicating that ED is independently associated with depressive symptoms even though patients were approximately 4 years post diagnosis. These cross-sectional data suggest ED in men with prostate cancer can have lasting psychological effects.
INTRODUCTION: The relationship between erectile dysfunction (ED) and depressive symptoms is well established. However, this relationship is not well explored in men with prostate cancer. Limited data suggest men with prostate cancer may experience less ED bother than men with ED who do not have prostate cancer, implying that ED and depressive symptoms may not be associated in men with prostate cancer. AIM: To determine if ED is associated with depressive symptoms in men with prostate cancer. MAIN OUTCOME MEASURES: Assessments of quality-of-life (The Functional Assessment of Cancer Therapy [FACT-P]), anxiety/depression (Hospital Anxiety and Depression Scale [HADS]), and erectile function. Erectile function was measured with one question from the FACT-P similar to that used by the Massachusetts Male Aging Study. METHODS:Men with prostate cancer, and naïve of hormone treatment, completed the study questionnaires at a single time point. RESULTS: The average age of the 339 men was 67±10 years. The average time since diagnosis was 3.9±3 years. When answering the question, "I am able to have and maintain an erection" on a 1 to 5 scale (5 representing the best function), the mean score was 2 indicating "a little bit." On univariate analysis, erectile function and depression were associated, r=-0.12, P<0.05. Other variables associated with depression were marital status, r=0.11, P<0.05; anxiety scores, r=0.56, P<0.01; and social support, r=-0.42, P<0.01. On multivariate analysis, erectile function remained a significant predictor of depression, beta=-0.10, P<0.05. CONCLUSIONS: Erectile function was associated with depressive symptoms in both univariate and multivariate analysis, indicating that ED is independently associated with depressive symptoms even though patients were approximately 4 years post diagnosis. These cross-sectional data suggest ED in men with prostate cancer can have lasting psychological effects.
Authors: Andrea M Tavlarides; Steven C Ames; David D Thiel; Nancy N Diehl; Alexander S Parker Journal: Psychooncology Date: 2014-06-21 Impact factor: 3.894
Authors: David-Dan Nguyen; Alejandro Berlin; Andrew G Matthew; Nathan Perlis; Dean S Elterman Journal: Int J Impot Res Date: 2021-01-06 Impact factor: 2.896
Authors: Jennifer Barsky Reese; Kristen Sorice; Mary Catherine Beach; Laura S Porter; James A Tulsky; Mary B Daly; Stephen J Lepore Journal: J Cancer Surviv Date: 2016-11-17 Impact factor: 4.442
Authors: Maria Olsson; Gunnar Steineck; Karin Enskär; Ulrica Wilderäng; Marianne Jarfelt Journal: J Cancer Surviv Date: 2018-03-05 Impact factor: 4.442
Authors: Faysal A Yafi; Lawrence Jenkins; Maarten Albersen; Giovanni Corona; Andrea M Isidori; Shari Goldfarb; Mario Maggi; Christian J Nelson; Sharon Parish; Andrea Salonia; Ronny Tan; John P Mulhall; Wayne J G Hellstrom Journal: Nat Rev Dis Primers Date: 2016-02-04 Impact factor: 52.329