Evaluating depression, anxiety, and patterns of mental health care in patients with prostate cancer receiving hormone therapy

This study evaluated depression, anxiety, and patterns of mental health care in patients with prostate cancer receiving hormonal therapy such as androgen deprivation therapy (ADT). The data showed that almost half of the patients with prostate cancer receiving ADT diagnosed with depression do not receive a documented mental health treatment.

Prostate cancer (PC) often grows in response to androgens (male sex hormones such as testosterone). These patients are usually treated with androgen-deprivation therapy (ADT). ADT reduces the production of androgens. Reducing these androgens prevents cancer cell growth.

ADT is associated with an increased risk of developing depression and anxiety in men with PC. These side effects reduce QoL in patients. However, little is known about how the mental health of these patients is treated.

This study involved 37,388 men with PC treated with ADT. 10.6% (3964) of these patients received a new diagnosis of depression or anxiety.

Of those 3964 patients who received a diagnosis of depression or anxiety, 47.7% (1892) did not receive a documented treatment. 0.3% (10) of these received psychotherapy, 33.3% (1321) received a selective serotonin reuptake inhibitor (SSRI; a type of anti-depression medication), and 18.8% (744) received benzodiazepines (a type of anti-anxiety medication).

The average time from initiation of ADT to a depression or anxiety diagnosis was 9.3 months. Primary care physicians were the most common prescribers of psychotropic medications (72.2%).

The proportion of men not receiving mental health treatments of interest (47.7%) was similar compared to men without prostate cancer (49.1%), but significantly lower when compared to men with prostate cancer not receiving ADT (52.7%).

This study concluded that almost half of the men with PC who develop depression or anxiety after starting ADT do not receive a documented mental health treatment while 19% of the patients received treatment with benzodiazepines.

This study only included patients with commercial insurance. The definition of depression and anxiety was limited to diagnostic codes and this may not allow physicians to always identify patients with cancer experiencing distress.

If you feel distress due to your PC diagnosis or treatment, please discuss this with your doctor.