The EPIC-26 domain scores after radical prostatectomy are associated with the personality trait of neuroticism

Alv A Dahl,Karol Axcrona,Sophie D Fosså,Bjørn Brennhovd

doi:10.1007/s11255-020-02688-4

Abstract

PurposeThe personality trait of neuroticism represents vulnerability for mental distress to somatic health problems. There are few studies of neuroticism in prostate cancer patients. This study examines the levels of self-reported adverse effects (AEs) after robot-assisted radical prostatectomy (RALP) in Norwegian men with high or low levels of neuroticism. Neuroticism is also compared to relevant factors concerning their associations with various AEs.MethodsAmong 982 men who had RALP at Oslo University Hospital, Radiumhospitalet between 2005 and 2010, 79% responded to a mailed questionnaire in 2011. They rated AEs by completing the EPIC-26 questionnaire, and neuroticism on the Eysenck Personality Questionnaire (EPQ). Men with < 1 year’s follow-up, treatment failure, and incomplete EPQ responses were omitted, leaving 524 men for analysis. The EPQ responses were dichotomized into low and high level of neuroticism. Stepwise multivariate linear regression analyses were used for examination of associations with the EPIC-26 domain scores.ResultsHigh neuroticism was reported by 20% (95% CI 17–23%) of the patients. On the EPIC-26 dimensions men with high neuroticism had significantly lower mean scores than men with low neuroticism. Most of these between-group differences were clinically significant. In multivariate regression analyses, high neuroticism contributed significantly to all EPIC-26 domains.ConclusionIncreased levels of AEs after RALP are significantly associated with high neuroticism. A short screening test should be added to the current EPIC-26 instrument to identify patients with high neuroticism. In these patients, pre-operative counseling should take into account their risk of increased AE experiences.

Highlights

Curative treatments of prostate cancer (PCa) have relatively high rates of well-known adverse effects (AEs) with urinary incontinence and erectile dysfunction being most common after robot-assisted laparoscopic prostatectomy (RALP) [1, 2]
The socio-demographic step made significant contribution to the sexual and hormonal domains, while the PCa-related step only contributed to the sexual domain, and the comorbidity step to the hormone domain.High neuroticism was negatively associated with each of the five EPIC26 domain scores, and the highest explained variances emerged for the sexual and hormonal domain scores
Representing a new observation, the results support our hypothesis of a positive association between high neuroticism and decreased levels of EPIC-26 domains scores

Summary

Introduction

Curative treatments of prostate cancer (PCa) have relatively high rates of well-known adverse effects (AEs) with urinary incontinence and erectile dysfunction being most common after robot-assisted laparoscopic prostatectomy (RALP) [1, 2]. AEs can be registered by health personnel, but in recent years, patient-reported outcome measures (PROMS) have become popular. Among PROMS relevant for men treated for PCa, the Expanded Prostate Cancer Index Composite Short Form with 26 items (EPIC-26) has been recommended [3, 4]. Psychological factors are of obvious relevance for men treated with radical intention for PCa [5], few studies have examined associations between self-reported AEs and central psychological concepts such as personality. Basic personality traits show considerable stability throughout the life cycle [6]. Modern personality theory mostly describes five basic personality traits (“the big five”) [7], and neuroticism is the most important one concerning health and disease [8]

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Results

Conclusion