Yesterday I wrote about the cognitive effects of hormone therapy (ADT), today’s topic is about depression in men on ADT. It is commonly known that men on ADT often experience many physical and psychological side effects of the treatment. One of these side effects to ADT may be associated with increased risk for depression, but the relationship between ADT and depression is not fully understood.
In a longitudinal study designed to assess depression in men receiving hormone therapy (ADT) researchers compared two study groups of men with prostate cancer against a matched control group of men without a prostate cancer diagnosis.
Participants in the study were men diagnosed with prostate cancer who were initiating ADT treatment (ADT + group support) and ADT without group support and their matched no prostate cancer controls.
Depressive symptomatology was assessed using the Center for Epidemiological Studies Depression Scale at ADT initiation and again at 6 months. Differences in depressive symptomatology and rates of clinically significant depressive symptomatology were analyzed between groups at each time point and within groups over time.
Rates of clinically significant depressive symptomatology were higher in the ADT+ group support than the ADT without support and the non cancer control without support at both time points. Although exhibiting less depressive symptomatology than the ADT+ group the ADT without support group also exhibited more depression than the non-cancer control group. This finding leads to our asking if the depression comes from having a cancer diagnosis and it group support encourages feelings of depression.
Despite these questions, the most important finding supports the general hypothesis that men diagnosed with cancer and possibly those receiving ADT are subject to increases in depression.
This leads us to conclude that the mechanism behind receiving a cancer diagnosis and ADT’s association with depression should be further explored. Prostate cancer survivors, including those who are being treated with ADT should receive particular focus in depression screening and intervention. P
Psychooncology. 2014 Jun 13. doi: 10.1002/pon.3608. [Epub ahead of print]; Lee M1, Jim HS, Fishman M, Zachariah B, Heysek R, Biagioli M, Jacobsen PB.
http://www.ncbi.nlm.nih.gov/pubmed/24924331
PMID: 24924331
Joel T. Nowak, M.A., M.S.W.
An interesting study Joel. An important missing variable was the focus of the support groups. Twelve years ago when my prostate was removed, I attended two different support groups. The members of the first group spent the entire time sharing everything they missed as the result of prostate cancer. The second group consisting of advanced prostate cancer survivors focused on how little time they had left to live.
I think the study could be replicated by differentiating between the focus of support groups. I’d venture to say that men in groups looking for how to adapt to living with prostate cancer might show less depression than those consumed with venting the loss.
Stan – As usual you have great insight. – Joel