Psychological Distress In Men Research Articles

Cancer-related symptoms, mental well-being, and psychological distress in men diagnosed with prostate cancer treated with androgen deprivation therapy

PurposeThere are known associations between treatment of prostate cancer (PCa) involving Androgen Deprivation Therapy (ADT) and psychological and physical side effects. We investigate the associations between cancer-related symptoms, health-related quality of life (HRQL), and poor psychological outcomes in men whose treatment for PCa involved ADT.MethodsA cross-sectional postal questionnaire was administered to UK men 18–42 months post diagnosis of PCa. Men completed items on functional outcomes using the Expanded Prostate Cancer Index Composite (EPIC-26), EuroQol-5D (EQ-5D), and the European Organisation for Research and Treatment of Cancer (EORTC) Fatigue subscale. Psychological outcomes (mental well-being and psychological distress) were assessed using the Short Warwick–Edinburgh Mental Well-being Scale (SWEMWBS) and the Kessler 6-item scale (K6), respectively. Associations between explanatory variables and psychological outcomes were assessed using stepped logistic regression.Results13,097 men treated with ADT completed a questionnaire. A minority of men reported poor mental well-being (15.5%) or severe psychological distress (6.6%). After controlling for sociodemographic and clinical variables, reporting clinically significant fatigue was strongly associated with severe psychological distress (OR 9.92; 95% CI 7.63 to 12.89) and poor well-being (OR 3.86; 95% CI 3.38 to 4.42). All cancer-related symptoms and HRQL variables were associated with both psychological outcomes.ConclusionsWhile the majority of men treated with ADT did not report poor psychological outcomes, a small proportion reported severe problems. Clinically significant fatigue was demonstrated as a possible indicator of poor outcomes. Healthcare systems need to have clear protocols in place which specifically and routinely target psychological distress and fatigue.

Informal caregiving patterns and trajectories of psychological distress in the UK Household Longitudinal Study.

Approximately seven million people in the UK are engaged in informal caregiving. Informal caregivers are at risk of poorer mental and physical health. However, less is known about how the relationship between the informal caregiving and psychological distress changes over time. The aim of this study was to investigate longitudinal associations between the informal caregiving and psychological distress amongst UK men and women aged 16+. Data were analysed from the UK Household Longitudinal Study (UKHLS, n = 9368), a nationally representative study of UK households. Longitudinal linear mixed modelling was used to estimate associations between the longitudinal patterns of informal caregiving (non-caregiver/one episode of 1-2 years/intermittent caregiving/3+ years caregiving) and trajectories of psychological distress across seven waves of UKHLS data. Informal caregiving was not associated with psychological distress for men. Women engaged in long-term (⩾3 years) or intermittent caregiving had higher levels of psychological distress at the point of initiation, compared with women who were not caregivers throughout the study period (3+ years caregiver: regression coefficient 0.48, 95% confidence interval (CI) 0.07-0.89; intermittent caregiver: regression coefficient 0.47, 95% CI 0.02-0.92). Trajectories of psychological distress changed little over time, suggesting a plateau effect for these caregiving women. Women engaged in long-term or repeated shorter episodes of informal caregiving reported more symptoms of psychological distress than non-caregiving women. Given the increased risk of reporting psychological distress and the increasing importance of the informal care sector, the risk of poorer mental health of informal caregivers should be a priority for public health.

Gender differences in the effects of job insecurity on psychological distress in Japanese workers: a population-based panel study.

This study aimed to examine effects of persistence or change in job insecurity on psychological distress (PD) among Japanese community dwellers. The sample comprised 889 men and 762 women aged 25-50years who were employed and completed both wave 1 (2010) and wave 2 (2012) surveys of the Japanese Study on Stratification, Health, Income, and Neighborhood (J-SHINE). Job insecurity, a perception of threat of job loss, was self-reported in both waves to define persistence and change of the status. Logistic regression analysis was performed to compare PD (K6 score ≥ 5) at wave 2 for employees whose job security changed or who remained insecure with that of those who remained secure. Persistent job insecurity was associated with PD (for men, OR 1.64, 95% CI 1.03-2.63; for women OR 1.65, 95% CI 1.02-2.65), after adjustment for confounders. Additionally, change from secure to insecure perception was also associated with PD in men, while change from insecure to secure was associated with PD in women. Regardless of gender, these effects were observable among workers with children but not among those without children. Persistent job insecurity and change in job insecurity has adverse effects on PD, especially for workers with children. Gender differences in the effects of change in job security on PD might be explained by the social norms of gender roles and labor market gender segregation. Policy makers should consider dependent family and gender inequalities when developing policies to reduce job insecurity and its negative health effects.

Educational differences in psychological distress? Results from a population-based sample of men and women in Sweden in 2012

BackgroundMental health problems are more frequent in socially disadvantaged groups, but the results vary between different studies, different populations and different measures of mental health. This paper investigated the association...

Psychological distress in men with prostate cancer and their partners before and after cancer diagnosis: a longitudinal study.

To examine the relative risk of psychological distress of men with prostate cancer and their partners during the period before and after prostate cancer diagnosis compared with men without prostate cancer and their partners. The participants reported questionnaires on psychological distress at four time points: before prostate cancer biopsy, and at 1, 3 and 6 months following prostate cancer diagnosis. We performed multiple logistic regression analyses to examine the relative risk of psychological distress. A total of 115 couples answered the questionnaires at all four time points. Men with prostate cancer showed a significantly higher risk of psychological distress compared to men without prostate cancer at 1 (odds ratio [OR] = 4.8, 95% confidence interval [CI] = 1.9-13.1), 3 (OR = 3.2, 95% CI = 1.1-10.2) and 6 months following prostate cancer diagnosis (OR = 6.9, 95% CI = 2.3-25.7). Their partners showed a significantly higher risk of psychological distress compared to the partners of men without prostate cancer at 1 month following prostate cancer diagnosis (OR = 2.6, 95% CI = 1.1-6.6). Men with prostate cancer showed psychological distress during the 6 months following the cancer diagnosis. Their partners also showed psychological distress at 1 month following the cancer diagnosis. Inviting both men with prostate cancer and their partners to speak to their concerns, empathizing with them, finding the solutions together and monitoring of their psychological status regularly should be regarded as important following prostate cancer diagnosis.

Psychosocial work factors and social inequalities in psychological distress: a population-based study

BackgroundMental health problems (MHP) are the leading cause of disability worldwide. The inverse association between socioeconomic position (SEP) and MHP has been well documented. There is prospective evidence that factors from the work environment, including adverse psychosocial work factors, could contribute to the development of MHP including psychological distress. However, the contribution of psychosocial work factors to social inequalities in MHP remains unclear. This study evaluates the contribution of psychosocial work factors from two highly supported models, the Demand-Control-Support (DCS) and the Effort-Reward Imbalance (ERI) models to SEP inequalities of psychological distress in men and women from a population-based sample of Quebec workers.MethodsData were collected during a survey on working conditions, health and safety at work. SEP was evaluated using education, occupation and household income. Psychosocial work factors and psychological distress were assessed using validated instruments. Mean differences (MD) in the score of psychological distress were estimated separately for men and women.ResultsLow education level and low household income were associated with psychological distress among men (MD, 0.56 (95% CI 0.06; 1.05) and 1.26 (95% CI 0.79; 1.73) respectively). In men, the contribution of psychosocial work factors from the DCS and the ERI models to the association between household income and psychological distress ranged from 9% to 24%. No clear inequalities were observed among women.ConclusionsThese results suggest that psychosocial work factors from the DCS and the ERI models contribute to explain a part of social inequalities in psychological distress among men. Psychosocial factors at work are frequent and modifiable. The present study supports the relevance of targeting these factors for the primary prevention of MHP and for health policies aiming to reduce social inequalities in mental health.

Triple difficulties in Japanese women with hearing loss: marriage, smoking, and mental health issues.

ObjectiveTo examine the consequences of early-onset hearing loss on several social and health measures and any related gender differences in Japanese populations.MethodsData from a 2007 nationally representative cross-sectional household survey of 136,849 men and women aged 20 to 39 years were obtained (prevalence of self-reported hearing loss: 0.74%). We focused particularly on four social and health measures: employment status (employed/unemployed), marital status (married/unmarried), smoking behavior (yes/no), and psychological distress (K6 instrument: ≥ 5 or not). We examined the association of hearing loss for each measure using generalized estimating equations to account for correlated individuals within households.FindingsThere was no significant association with employment status (p = 0.447). Men with hearing loss were more likely to be married, whereas women with hearing loss were less likely to be married (p < 0.001 for interaction). Although hearing loss was not associated with a current smoking status in men, women with hearing loss were more likely to be current smokers (p < 0.001 for interaction). Moreover, hearing loss was associated with psychological distress in men and women (both p < 0.001).ConclusionThese findings suggest that hearing loss is related to social and health issues in daily life, including a lower likelihood of marriage, more frequent smoking, and poorer mental health, especially in women. These issues may reflect a gap between the actual needs of women with hearing loss and the formal support received as a result of existing public health policies in Japan.

Improvements in closeness, communication, and psychological distress mediate effects of couple therapy for veterans.

Empirically based couple therapy results in significant improvements in relationship satisfaction for the average couple; however, further research is needed to identify mediators that lead to change and to ensure that improvements in mediators predict subsequent-not just concurrent-relationship satisfaction. In addition, given that much of the current literature on couple therapy examines outcomes in a research environment, it is important to examine mediators in a treatment-as-usual setting. To address these questions, 161 heterosexual couples (322 individuals) received treatment-as-usual couple therapy at one of two Veteran Administration Medical Centers (M = 5.0 and 13.0 sessions at the two sites) and were assessed before every session. The majority of couples were married (85%) and had been together for a median of 7.8 years (SD = 13). Participants were primarily White, non-Hispanic (69%), African American (21%), and White, Hispanic/Latino (8%). Individuals' own self-reported improvements in communication, emotional closeness, and psychological distress (but not frequency of behaviors targeted in treatment) mediated the effect of treatment on their subsequent relationship satisfaction. When all significant mediators were examined simultaneously, improvements in men's and women's emotional closeness and men's psychological distress independently mediated subsequent relationship satisfaction. In contrast, improvements in earlier relationship satisfaction mediated the effect of treatment only on subsequent psychological distress. This study identifies unique mediators of treatment effects and shows that gains in mechanisms predict subsequent relationship satisfaction. Future investigations should focus on the role of emotional closeness and psychological distress-constructs that have often been neglected-in couple therapy. (PsycINFO Database Record

Communication and interpretation of emotional distress within the friendships of young Irish men prior to suicide: a qualitative study.

The potential for young men in crisis to be supported by their lay networks is an important issue for suicide prevention, due to the under-utilisation of healthcare services by this population. Central to the provision of lay support is the capability of social networks to recognise and respond effectively to young men's psychological distress and suicide risk. The aim of this qualitative study was to explore young men's narratives of peer suicide, in order to identify how they interpreted and responded to behavioural changes and indications of distress from their friend before suicide. In-depth qualitative interviews were conducted during 2009/10 with 15 Irish males (aged 19-30 years) who had experienced the death by suicide of a male friend in the preceding 5 years. The data were analysed using a thematic approach. Through the analysis of the participants' stories and experiences, we identified several features of young male friendships and social interactions that could be addressed to strengthen the support available to young men in crisis. These included the reluctance of young men to discuss emotional or personal issues within male friendships; the tendency to reveal worries and emotion only within the context of alcohol consumption; the tendency of friends to respond in a dismissive or disapproving way to communication of suicidal thoughts; the difficulty of knowing how to interpret a friend's inconsistent or ambiguous behaviour prior to suicide; and beliefs about the sort of person who takes their own life. Community-based suicide prevention initiatives must enhance the potential of young male social networks to support young men in crisis, through specific provisions for developing openness in communication and responsiveness, and improved education about suicide risk.

Retirement, age, gender and mental health: findings from the 45 and Up Study

Objectives: To examine the relationships of retirement and reasons for retirement with psychological distress in men and women at the age of 45–79 years.Method: Data from 202,584 Australians participating in the large-scale 45 and Up Study was used. Psychological distress was measured by the Kessler psychological distress scale. Associations between different work status and reasons for retirement with psychological distress were assessed for men and women at different ages using logistic regression.Results: Being fully retired or unemployed was associated with the high levels of psychological distress compared to being in paid work for men and women aged 45–64 (p < 0.0001), and for men aged 65–74 years (p ≤ 0.0014). At the age of 75–79 years, there was no difference in psychological distress between different work statuses. Among retirees, retirement due to ill health, being made redundant or caring duty was associated with the high level of psychological distress.Conclusion: The association between work and mental health underscores the importance of policies and strategies to encourage and enable people to continue in the workforce after age 55, particularly for men. Important reasons for retirement with worse mental health outcomes include redundancy, ill health and needing to care for family or a friend. These circumstances will affect whether a person can continue working and their risk of poor mental health, and both considerations should be addressed in developing approaches for maintaining older workers or assisting them with their retirement transition.

Which socio-economic measures are associated with psychological distress for men and women? A cohort analysis.

There are contradictory results regarding whether there is a social gradient in common mental disorders or not, or if this relation differs for different indicators or by gender. We analysed the relation between various measures of socio-economic position and later psychological distress among men and women in a Swedish context. The study is based on data from the Northern Swedish Cohort (N = 1001, 93.5% response rate), a 27-year prospective study. Logistic regression was used to explore the relation between various indicators of socio-economic position at age 30 (occupation, education, financial strain, cash margin, unemployment and living primarily on social welfare or unemployment insurance) and psychological distress (age 42), controlling for earlier psychological distress (age 21) and parental occupational class. Register data were used to measure unemployment. All other variables were self-reported, and measured by a questionnaire. Financial strain and living on social welfare or unemployment insurance at age 30 were associated with psychological distress at age 42 for men and women. Poor cash margin and unemployment were only associated with psychological distress in women, after controlling for potential confounders. Low occupational class and low education were not significantly related to later psychological distress. The two most commonly used measures of socio-economic position, occupation and education, were not significantly associated with psychological distress while other, less studied measures were. This study highlights the importance of measuring socio-economic position in several ways when studying common mental disorders, as well as to take gender into account.

My Road Ahead study protocol: a randomised controlled trial of an online psychological intervention for men following treatment for localised prostate cancer

BackgroundThere is a need for psychosocial interventions for men with prostate cancer to promote adaptive coping with the challenges and distress associated with diagnosis, treatment and recovery. In addition, interventions are needed that help to overcome barriers to psychosocial treatment such as limited face-to-face psychosocial support services, a shortage of adequately trained professionals, geographical distance, perceived and personal stigma and a preference for consumer-centric and self-directed learning. My Road Ahead is an online cognitive behaviour therapy (CBT) intervention for prostate cancer. This protocol describes a randomised controlled trial (RCT) that will evaluate the efficacy of this online intervention alone, the intervention in combination with a moderated online forum, and the moderated online forum alone.Methods/designThis study utilises a RCT design with three groups receiving: 1) the 6-module My Road Ahead intervention alone; 2) the My Road Ahead intervention plus a moderated online forum; and 3) the moderated online forum alone. It is expected that 150 men with localised prostate cancer will be recruited into the RCT. Online measures will assess men’s psychological distress as well as sexual and relationship adjustment at baseline, post-intervention, 3 month follow-up and 6 month follow-up. The study is being conducted in Australia and participants will be recruited from April 2012 to Feb 2014. The primary aim of this study is to evaluate the efficacy of My Road Ahead in reducing psychological distress.DiscussionTo our knowledge, My Road Ahead is the first self-directed online psychological intervention developed for men who have been treated for localised prostate cancer. The RCT will assess the efficacy of this intervention in improving psychological well-being, sexual satisfaction, relationship satisfaction and overall quality of life. If successful, this intervention could provide much needed support to men receiving treatment for localised prostate cancer in a highly accessible manner.Trial registrationAustralian New Zealand Clinical Trials Registry Identifier: ACTRN12611000278932

Psychological distress, gender and dietary factors in South Asians: a cross-sectional survey.

Psychological distress, defined as symptoms of depression and anxiety, is an increasingly important public health issue in developing countries. Little is known about the extent to which adverse dietary factors are associated with psychological distress in South Asians. Our aim was to compare the associations of diet and psychological distress in men and women in Goa, India. Cross-sectional study of consecutive attendees in nine urban and rural general practices in Goa, India in 2004-2005. All participants completed an FFQ on their dietary intake in a typical week. Psychological distress was measured using the Kessler Psychological Distress Scale (K10), a WHO-validated screening instrument. Consecutive attendees (n 1512; 601 men and 911 women) aged 30 to 75 years participated. Moderate and high scores of psychological distress were detected in significantly more women than men (eighty-eight men v. 264 women, unadjusted OR = 0·39; 95 % CI 0·29, 0·52). Those who ate one or more portions of fish weekly had nearly half the prevalence of distress in both sexes (women, OR = 0·52; 95 % CI 0·29, 0·91; men, OR = 0·50; 95 % CI 0·25, 0·99) and this was independent of age, marital status, education, income, religion and living alone. Psychological distress is significantly lower with fish intake in both sexes. Further longitudinal work is needed to establish temporal relationships. Addressing psychological distress is becoming an increasingly significant public health priority in both high- and low-income countries.

Couple distress after localised prostate cancer

The experience of the diagnosis of prostate cancer is distressing for both men and their partners. The present study describes the prevalence of psychological distress in men with prostate cancer and their partners, and the predictors of adjustment outcomes. A cross-sectional survey of 189 prostate cancer patients who were scheduled for or had undergone surgery for localised prostate cancer and their partners assessed socio-demographic variables, masculine self-esteem and social intimacy, psychological adjustment and quality of life. Overall, patients and partners reported low distress; however, female partners were more anxious with 36 % reporting mild to severe anxiety. For men, masculine self-esteem and time since diagnosis were most strongly related to mental health status; urinary bother most influenced physical quality of life. For female partners, the man's psychological distress and his sexual bother were most strongly related to her mental health status; higher social intimacy was most strongly associated with physical quality of life. The correlates of distress after the diagnosis of prostate cancer differ between patients and female partners. For men, masculine self-esteem may be most crucial, whereas for women, her partner's level of distress may matter most. Research to better understand these interactions is needed.

A Population-Based Study Investigating the Association Between Sexual and Relationship Satisfaction and Psychological Distress Among Heterosexuals

This study examined whether sexual/relationship satisfaction are differentially associated with mental health issues. Using data from a population-based computer-assisted telephone survey, the authors included in this study 3,800 respondents who had a regular heterosexual partner. The authors used 2 methods of scoring the K6 to produce measures of moderate psychological distress and serious psychological distress. Overall, 8.8% of men and 12.1% of women were classified as having moderate psychological distress, whereas 1.6% of men and 3.2% of women were classified as currently experiencing serious psychological distress. The association between satisfaction and mental health was influenced by sex and the severity of the mental health issue but not by type of satisfaction. After adjusting for demographic differences in mental health, low ratings of sexual/relationship satisfaction were both consistently associated with higher levels of moderate psychological distress in men and women and higher proportions of serious psychological distress in men. Although women may be able to resolve their satisfaction issues during less severe stages of psychological distress, for men there was a strong association between low sexual/relationship satisfaction and serious psychological distress.

DUAL MINORITY STRESS AND ASIAN AMERICAN GAY MEN'S PSYCHOLOGICAL DISTRESS

The present study investigated the direct and additive effects of racial minority stress and sexual minority stress on the psychological well‐being among a community sample of 139 Asian American gay men. Self‐esteem was tested to see whether it moderated or mediated the effects of perceived dual minority stress on psychological distress. Results revealed that sexual minority stress predicted self‐esteem and both were predictors of psychological distress. Racial minority stress did not predict psychological distress. Contrary to the minority stress model existing in the current literature, the added disadvantages of racial/ethnic minority status did not increase Asian American gay men's psychological distress. Self‐esteem did not mediate or moderate the relationships between minority stresses and psychological distress. These findings highlight the robust effects of stresses related to one'es homosexuality on psychological well‐being and suggest that self‐esteem may not always protect against multiple discriminations for Asian American gay men. © 2012 Wiley Periodicals, Inc.

Erectile Dysfunction is the Main Determinant of Psychological Distress in Men with Spinal Cord Injury

The weight of erectile dysfunction (ED) among the various determinants of psychological distress in men with spinal cord injury (SCI) remains to be clarified. The aim of this article was to evaluate psychological distress features in SCI men with or without ED. Forty consecutive patients with neurologically stable SCI were included in the study. Functional independence (FI) was assessed by Barthel Index (BI), which was divided into global score (questions 1-10) and bowel/bladder subscore (questions 5 and 6). Erectile function was evaluated with Sexual Health Inventory for Men (SHIM). Psychological distress was assessed with the Symptom Checklist-90-revised (SCL-90-R), scoring nine primary dimensions and their combination as Global Severity Index, a global index of psychological distress. All SCL-90-R scores and the percentage of patients with scores >75th percentile of the entire study population were significantly higher in the group with ED (N=21) than without ED (N=19). Most of SCL-90-R subscales were inversely correlated with SHIM score. ED was exhibited by a high proportion (84%) of men with thoracolumbar lesions but by no patients with cervical lesions. Men with cervical lesions exhibited significantly lower SCL-90-R scores than those with thoracolumbar lesions, in spite of lower FI. However, the thoracolumbar group also reported a more severe bowel/bladder dysfunction. At multivariate logistic regression analysis, ED score significantly explained the variance of most of SCL-90-R dimension scores, whereas no association was revealed between global BI and any score of SCL-90-R dimensions. Bowel/bladder BI explained only to a very low extent the variance of depressive symptoms. Healthcare providers should be aware of the importance of managing ED in spinal cord-injured men, as it represents a major determinant of their psychological distress, independently of the degree of FI impairment.

Non-medical Use of Prescription Opioids Among Ontario Adults: Data From the 2008/2009 CAMH Monitor

Objective: There are indications that non-medical prescription opioid analgesics use (NMPOU) in the general population has increased in Canada in recent years; however, existing estimates have limitations. Thus our objectives are to determine prevalence and associated demographics of 1) prescription opioid analgesics (PO) use, 2) NMPOU, and 3) use of PO for intoxication purposes in the adult population in Ontario. Methods: Prevalence and the associations between sex, age, region, income, cigarette smoking, binge drinking, cannabis use and psychological distress with the above-noted types of PO use were assessed using data from the 2008 and 2009 samples (n=2030) of the CAMH Monitor. The statistical significance of the associations for all types of PO use was tested through bivariate associations using chi-square tests, and a two-step logistic regression was performed to test if demographics are associated with NMPOU. Results: The prevalence of PO use was 21.3% (95% CI 19.1–23.4), and the prevalence of NMPOU was 2.0% (95% CI 1.2–2.8) of Ontario adults. There were no significant differences between men and women for either PO use or NMPOU. Bivariate associations indicated that NMPOU was associated with tobacco and cannabis use and psychological distress in men. Logistic regression showed a significant association between NMPOU and each of age, cannabis use, and psychological distress in men. Discussion: NMPOU is an emerging epidemic in Canada across all income and age groups, and is associated with other substance use and mental health problems. Improved survey designs are required for more accurate population estimates of NMPOU.

Non-medical Use of Prescription Opioids Among Ontario Adults: Data From the 2008/2009 CAMH Monitor

There are indications that non-medical prescription opioid analgesics use (NMPOU) in the general population has increased in Canada in recent years; however, existing estimates have limitations. Thus our objectives are to determine prevalence and associated demographics of 1) prescription opioid analgesics (PO) use, 2) NMPOU, and 3) use of PO for intoxication purposes in the adult population in Ontario. Prevalence and the associations between sex, age, region, income, cigarette smoking, binge drinking, cannabis use and psychological distress with the above-noted types of PO use were assessed using data from the 2008 and 2009 samples (n = 2030) of the CAMH Monitor. The statistical significance of the associations for all types of PO use was tested through bivariate associations using chi-square tests, and a two-step logistic regression was performed to test if demographics are associated with NMPOU. The prevalence of PO use was 21.3% (95% CI 19.1-23.4), and the prevalence of NMPOU was 2.0% (95% CI 1.2-2.8) of Ontario adults. There were no significant differences between men and women for either PO use or NMPOU. Bivariate associations indicated that NMPOU was associated with tobacco and cannabis use and psychological distress in men. Logistic regression showed a significant association between NMPOU and each of age, cannabis use, and psychological distress in men. NMPOU is an emerging epidemic in Canada across all income and age groups, and is associated with other substance use and mental health problems. Improved survey designs are required for more accurate population estimates of NMPOU.

Psychological distress in men with prostate cancer receiving adjuvant androgen-deprivation therapy

ObjectivesTo compare the occurrence of depression, anxiety, self body image perception, sleep disturbances, and diminished quality of life in prostate cancer patients undergoing adjuvant androgen-deprivation therapy (ADT) as opposed to patients in follow-up alone. Methods and materialsHospital Anxiety and Depression Scale, Pittsburgh Sleep Quality Index, Restless Legs Syndrome Study Group essential diagnostic criteria, Body Image Scale and Functional Assessment of Cancer Therapy Prostate were administered to consecutive prostate cancer patients who underwent radical prostatectomy or radiation therapy and are presently either under adjuvant ADT or included in a follow-up program. ResultsOf the 103 patients enrolled, 49 (47.6%) were receiving adjuvant ADT and 54 (52.4%) were not. Compared with the controls, the patients undergoing ADT showed higher levels of depression (P = 0.002), worse self body image perception (P = 0.001), worse quality of life (P = 0.0001) and worse sleep quality (P = 0.04). ADT was significantly associated with depression at multivariate analysis after adjustment for age, stage, Gleason score, as well as demographic and social variables (P = 0.001). Depression scores showed a strong inverse correlation with quality of life scores (P < 0.01). ConclusionsAdjuvant ADT is associated with depression, worse quality of life, and altered self body image in prostate cancer patients.