Factors associated with depressive symptoms in patients with metastases from prostate cancer

Abstract

9131 Background: The purpose of this study was to identify predictive factors of depression in patients with metastases from prostate cancer. Methods: Patients with evidence of metastases from prostate cancer were prospectively screened for depression. Depressive symptoms were defined by the Beck Depression Inventory-Short Form (BDI-SF) with a low cut-off score of 4 to optimize sensitivity as a screening test (Lowe AW, 2004). Self-report questionnaires including BDI-SF were sent to pts through the mail and then given back to the oncologist. In case of a BDI-SF > 4, a consultation with a psychiatrist was proposed, so that the diagnosis of depression could be made and treatment be started. Characteristics including marital status, spiritual well-being, educational level, ongoing treatment for prostate cancer, and the presence of pain requiring analgesic therapy were registered. Results: 92 patients were prospectively enrolled of whom 54 (60%) completed the self-report questionnaires. Median age was 69 years (range: 50–84). 31 pts (54%) had castration-refractory disease, of whom 30 were receiving chemotherapy: docetaxel (n=22), carboplatin-etoposide (n=6) and doxorubicin (n=2). Eighteen patients (33%) had a BDI-SF score > 4, of whom 10 (18%) had a major depressive disorder (MDD) according to the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) criteria. Logistic regression analysis showed that pain requiring analgesic therapy was the only predictive factor of depressive symptoms (OR=3.75; 95% confidence interval 1.1–12.4). In patients with pain requiring treatment, the incidence of depressive symptoms and MDD was 53% and 32%, respectively. In contrast to female with advanced breast cancer (Conforti R, 2004), marital status and belief in god were not predictive factors of depressive symptoms in this population of males. Conclusions: Pain requiring analgesic treatment was the only factor significantly associated with depressive symptoms in this sample of 54 patients with metastatic prostate cancer. A screening for depression should be systematically implemented at least in this subgroup of patients. No significant financial relationships to disclose.