Abstract
Androgen deprivation therapy (ADT) results in testosterone suppression, a hypothesized mechanism linking ADT to depressive symptoms. This study investigated the relationship between ADT and the risk of subsequently being diagnosed with depressive disorder (DD) during a 3-year follow-up period. The patient sample for this population-based, retrospective cohort study was retrieved from the Taiwan Longitudinal Health Insurance Database 2005. We included all 1714 patients aged over 40 years with a first-time diagnosis of prostate cancer (PC) during 2001 to 2010 who did not have an orchiectomy. Among them, we defined 868 patients who received ADT during the 3-year follow-up period as the study group, and 846 patients who did not receive ADT as the comparison group. The incidence rates of DD per 1000 person-years were 13.9 (95% confidence interval (CI): 9.5~19.6) and 6.7 (95% CI: 3.7~11.0), respectively. Cox proportional hazard regressions showed that the adjusted hazard ratio for DD for ADT recipients was 1.93 (95% CI: 1.03~3.62) relative to the comparison group. This study presents epidemiological evidence of an association between ADT and a subsequent DD diagnosis.
Highlights
Prostate cancer (PC) is the leading cancer among men in Western countries, with about 180,000 new prostate cancer cases diagnosed in 2016 [1]
Several studies by Lee, Shahinian, and Dinh reported that the rate of clinically significant depressive symptomatology was higher among PC patients treated with androgen deprivation therapy (ADT) than among those not treated with ADT [11,13,14]
PC patients who received ADT were on average, older than the comparison group (74.1 vs. 70.4 years, p
Summary
Prostate cancer (PC) is the leading cancer among men in Western countries, with about 180,000 new prostate cancer cases diagnosed in 2016 [1]. The mortality burden associated with PC is surpassed only by that of lung cancer [2]. PC remains a major health concern for older men. In the form of androgen deprivation therapy (ADT), is the standard care for newly diagnosed PC, and is increasingly accepted as an effective treatment modality.
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