Variation of Anxiety and Depression During a 3-Year Period as Well as Their Risk Factors and Prognostic Value in Postoperative Bladder Cancer Patients

Abstract

BackgroundAnxiety and depression are commonly recognized and prognostically relevant in cancer patients. The aim of this study was to explore the 3-year longitudinal changes in anxiety and depression, their risk factors, and prognostic value in patients with bladder cancer.MethodsHospital Anxiety and Depression Scale for anxiety (HADS-A) and depression (HADS-D) scores of 120 postoperative bladder cancer patients and 100 healthy controls (HCs) were assessed. Additionally, the HADS-A and HADS-D scores of bladder cancer patients were determined at 1 year, 2 years, and 3 years post surgery.ResultsHADS-A score (7.7 ± 3.0 vs. 4.8 ± 2.6), anxiety rate (38.3% vs. 9.0%), HADS-D score (7.7 ± 3.3 vs. 4.3 ± 2.6), depression rate (40.0% vs. 11.0%), as well as anxiety degree and depression degree, were all increased in bladder cancer patients compared with HCs (all P < 0.001). Besides, the HADS-A score gradually increased from baseline to 3 years (P = 0.004), while the anxiety rate, HADS-D score, and depression rate did not change significantly (all P > 0.050). Gender, tumor size, marriage status, hypertension, diversity, and lymph node (LN) metastasis were associated with anxiety or depression in patients with bladder cancer (all P < 0.050). Anxiety was associated with shortened overall survival (OS) (P = 0.024) but did not link with disease-free survival (DFS) (P = 0.201); depression was not correlated with either DFS or OS (both P > 0.050).ConclusionThe prevalence and severity of anxiety and depression are high in patients with bladder cancer, which are influenced by gender, tumor features, marriage status, and hypertension; in addition, their correlation with survival is relatively weak.