Abstract
OBJECTIVES:To determine the incidence of suicide risk in a group of patients who have been diagnosed with localized prostate cancer (PC) and to identify the factors that affect suicidal behavior.METHODS:Patients from a tertiary care oncology center in São Paulo, Brazil participated in this study and were interviewed after being diagnosed with low-risk or intermediate-risk PC, per the D'Amico risk classification, between September 2015 and March 2016. Patients underwent suicide risk assessment sessions using the Mini International Neuropsychiatric Interview (MINI), the Hospital Anxiety and Depression Scale (HADS), and the CAGE substance abuse screening tool before they started treatment and surveillance. Psychiatric treatment history, family history of suicidal behavior, and the use of psychotropic drugs were also examined.RESULTS:The prevalence of suicide risk among 250 patients who were recently diagnosed with low-risk or intermediate-risk PC was 4.8%. According to the HADS, 10.8% and 6.8% of patients had a positive score anxiety and for depression, respectively. Alcoholism was suspected in 2.8% of the group. Suicide risk was associated with anxiety (p=0.001); depression (p=0.005); being divorced, separated, widowed, or single (p=0.045); living alone (p=0.028); and prior psychological treatment (p=0.003).CONCLUSIONS:After being diagnosed with PC, patients who display risk factors for suicide should be monitored by a mental health team.
Highlights
In the past several decades, there has been an increase in the number of cancer diagnoses worldwide
The incidence of suicide risk for patients who were recently diagnosed with prostate cancer (PC) was 4.8%
Between the Hospital Anxiety and Depression Scale (HADS), CAGE, and Mini International Neuropsychiatric Interview (MINI) questionnaires, only the HADS results confirmed a correlation with suicide risk (p=0.001 for anxiety and p=0.005 for depression; Table 1)
Summary
In the past several decades, there has been an increase in the number of cancer diagnoses worldwide. Data from the WHO predict that 27 million people will develop cancer by 2030. In Brazil, the National Cancer Institute (INCA) estimates that 600,000 new cases will have developed in 20162017, with 61,200 new cases of prostate cancer (PC) and 13,772 deaths from PC [1]. In the US, 161,360 new PC cases and 26,730 deaths from PC are expected to occur annually [2]. The most common treatments for PC are surgery, radiotherapy, and hormone therapy. These modalities affect sexual [3,4], urinary [5], and intestinal function [4] to varying degrees, which often compromises the quality of life of patients and impacts their mental health [5]. Low-risk cases might be candidates for medical surveillance, requiring the patient to undergo periodic medical visits, evaluations of prostatespecific antigen (PSA) levels, rectal examination, magnetic
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