Pharmacologic androgen deprivation therapy (ADT) may be linked with an increased risk of depression and inpatient psychiatric treatment in elderly men with localized prostate cancer, according to a study published in the Journal of Clinical Oncology.
Researchers led by Kathryn Dinh, MD, MPH, of Harvard Medical School in Boston, MA, examined 78,552 men with stage 1 to 3 prostate cancer who were older than 65 years of age through a SEER-Medicare-linked database with patient information from 1992 to 2006. They excluded any patients with psychiatric diagnoses within the prior year.
Primary analysis was the association between pharmacologic ADT and diagnosis of depression or receipt of inpatient or outpatient psychiatric treatment through Cox proportional hazards regression. Secondary analysis looked at the association between duration of ADT and each endpoint.
Overall, the researchers found that 43% of patients who received ADT had higher 3-year cumulative incidences of depression, inpatient psychiatric treatment, and outpatient psychiatric treatment compared to patients who did not receive ADT.
Upon adjusted Cox analyses, they also found that patients who had undergone ADT had a 23% increased risk of depression, a 29% increased risk of inpatient psychiatric treatment, and a 7% increased risk of outpatient psychiatric treatment compared to patients without ADT.
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Risk of depression was found to increase with duration of ADT, with a 12% increased risk with at least 6 months of treatment, 26% increased risk with 7 to 11 months of treatment, and 37% increased risk with 12 months of treatment or more.
- Dinh KT, Reznor G, Muralidhar V, et al. Association of Androgen Deprivation Therapy With Depression in Localized Prostate Cancer. [published online ahead of print April 11, 2016] J Clin Oncol. doi:10.1200/JCO.2015.64.1969.