Do negative intrusive thoughts at diagnosis predict impaired quality of life, depressed mood and waking up with anxiety 3, 12 and 24 months after radical prostatectomy? – a longitudinal study

David Bock,Eva Angenete,Dan Asplund,Anders Bjartell,Stefan Carlsson,Jonas Hugosson,Karin Stinesen Kollberg,Anna Lantz,Hanna Nilsson,Mattias Prytz,Gunnar Steineck,Thordis Thorsteinsdottir,Peter Wiklund,Eva Haglind

doi:10.1080/21681805.2020.1754905

Abstract

Objective: To evaluate the effect of intrusive thoughts at diagnosis on quality of life, depressed mood and waking up with anxiety up to two years after radical prostatectomy.Method: The Laparoscopic Prostatectomy Robot Open (LAPPRO) trial was a prospective, longitudinal multicenter study of 4003 patients undergoing radical prostatectomy. Questionnaire data were collected preoperatively, at 3, 12 and 24 months after surgery.Results: The group of patients with intrusive thoughts at diagnosis had a statistically significant higher postoperative prevalence of impaired quality of life, depressed mood and waking up with anxiety as compared with the group of patients with no or minor intrusive thoughts. The highest risk increase for impaired QoL, depressed mood and waking up with anxiety ≥1/week was at 12, 3 and 3 months, respectively, where the three outcomes increased by 38% (RR: 1.38; 95%CI: 1.27–1.49)), 136% (RR: 2.36; 95%CI: 1.74–3.19)) and 165% (RR: 2.65; 95%CI: 2.22–3.17)), respectively.Conclusions: The demonstrated link between intrusive thoughts and quality of life, depressed mood and waking up with anxiety deliver is further evidence to the idea that intrusive thoughts has potential as an endpoint for assessing and predicting psychological distress among men with prostate cancer diagnosis.Trial registration number: ISRCTN06393679 (www.isrctn.com). Date of registration: 07/02/2008. Retrospectively registered.

Highlights

Prostate cancer is the second most frequently diagnosed cancer and the fifth leading cause of cancer death in men worldwide [1]
Facing a diagnosis of a life-threating disease such as prostate cancer is a life-changing trauma which may render a flood of emotions and thoughts that can be difficult to handle for the patient
According to the socialcognitive processing model [3], a traumatic event such as a cancer diagnosis is distressing because it challenges preexisting views of the self and the world [4]

Summary

Introduction

Prostate cancer is the second most frequently diagnosed cancer and the fifth leading cause of cancer death in men worldwide [1]. Facing a diagnosis of a life-threating disease such as prostate cancer is a life-changing trauma which may render a flood of emotions and thoughts that can be difficult to handle for the patient. According to the socialcognitive processing model [3], a traumatic event such as a cancer diagnosis is distressing because it challenges preexisting views of the self and the world [4]. By cognitively processing the trauma, the patient can accept and being able to deal with the diagnosis and thereby reduce the distress. Being able to be emotionally expressive in a supportive social environment is one important part of this process [3,5]

Methods

Results

Conclusion