Tim J Hartung1, Ida Rask Moustsen2, Signe Benzon Larsen2,3, Elisabeth A Wreford Andersen4, Nis P Suppli5, Christoffer Johansen6,2,7, Anne Tjønneland8,9, Anne S Friberg2,7, Susanne K Kjær10,11, Klaus Brasso3, Lars V Kessing12,13, Anja Mehnert6, Susanne Oksbjerg Dalton2. 1. Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Philipp-Rosenthal-Strasse 55, 04103, Leipzig, Germany. tim.hartung@medizin.uni-leipzig.de. 2. Unit of Survivorship, The Danish Cancer Society Research Center, Copenhagen, Denmark. 3. Copenhagen Prostate Cancer Center, Department of Urology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. 4. Statistics and Pharmacoepidemiology, The Danish Cancer Society Research Center, Copenhagen, Denmark. 5. Mental Health Centre Copenhagen, Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark. 6. Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Philipp-Rosenthal-Strasse 55, 04103, Leipzig, Germany. 7. Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. 8. Danish Cancer Society Research Center, Copenhagen, Denmark. 9. Department of Public Health, University of Copenhagen, Copenhagen, Denmark. 10. Unit of Virus, Lifestyle and Genes, The Danish Cancer Society Research Center, Copenhagen, Denmark. 11. Department of Gynecology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. 12. Psychiatric Center Copenhagen, Department O, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. 13. Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Abstract
PURPOSE: To estimate the risk of first-time antidepressant prescriptions as a proxy for depression or anxiety and associated risk factors in patients with prostate cancer and their female partners. METHODS: We followed all men (n = 25,126) and their female cohabiting partners (n = 8785) without a history of cancer or antidepressants from the Danish Diet, Cancer and Health cohort from 1997 to 2014 or 2010, respectively. We estimated the cumulative incidence of first-time antidepressant prescriptions in men with prostate cancer compared with cancer-free men and their respective female partners, using the Danish National Prescription Registry. Sociodemographic, lifestyle-related, and clinical risk factors were assessed using Cox regression models. RESULTS: A total of 1828 men were diagnosed with prostate cancer of whom 15% received antidepressants. The unadjusted hazard ratio of antidepressant prescription was 2.18 (95%CI, 1.92, 2.48) for men with prostate cancer and 1.27 (95%CI, 0.87, 1.85) for their partners, compared with cancer-free men and their partners, respectively. After adjusting for sociodemographic, lifestyle-related, and comorbidity factors, this risk was 2-fold to 4-fold increased among patients, but not significantly increased among partners. Significant risk factors among patients were curative and palliative treatment (vs. active surveillance and watchful waiting), nonlocalized disease, and short education. CONCLUSIONS: Men with prostate cancer have a higher risk of receiving antidepressant medication than cancer-free men. Clinical characteristics can help clinicians in identifying patients at a high risk of depression or anxiety. IMPLICATIONS FOR CANCER SURVIVORS: Men with prostate cancer who experience symptoms of depression or anxiety should seek professional help early on. Patient education could aid in raising awareness and reducing the stigma associated with mental disorders.
PURPOSE: To estimate the risk of first-time antidepressant prescriptions as a proxy for depression or anxiety and associated risk factors in patients with prostate cancer and their female partners. METHODS: We followed all men (n = 25,126) and their female cohabiting partners (n = 8785) without a history of cancer or antidepressants from the Danish Diet, Cancer and Health cohort from 1997 to 2014 or 2010, respectively. We estimated the cumulative incidence of first-time antidepressant prescriptions in men with prostate cancer compared with cancer-free men and their respective female partners, using the Danish National Prescription Registry. Sociodemographic, lifestyle-related, and clinical risk factors were assessed using Cox regression models. RESULTS: A total of 1828 men were diagnosed with prostate cancer of whom 15% received antidepressants. The unadjusted hazard ratio of antidepressant prescription was 2.18 (95%CI, 1.92, 2.48) for men with prostate cancer and 1.27 (95%CI, 0.87, 1.85) for their partners, compared with cancer-free men and their partners, respectively. After adjusting for sociodemographic, lifestyle-related, and comorbidity factors, this risk was 2-fold to 4-fold increased among patients, but not significantly increased among partners. Significant risk factors among patients were curative and palliative treatment (vs. active surveillance and watchful waiting), nonlocalized disease, and short education. CONCLUSIONS:Men with prostate cancer have a higher risk of receiving antidepressant medication than cancer-free men. Clinical characteristics can help clinicians in identifying patients at a high risk of depression or anxiety. IMPLICATIONS FOR CANCER SURVIVORS: Men with prostate cancer who experience symptoms of depression or anxiety should seek professional help early on. Patient education could aid in raising awareness and reducing the stigma associated with mental disorders.
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