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Decreasing suicide risk among patients with prostate cancer: Implications for depression, erectile dysfunction, and suicidal ideation screening

Urologic Oncology: Seminars and Original Investigations Oct 03, 2017

Klaassen Z, et al. - An appraisal was carried out of the interconnection between prostate cancer, depression, erectile dysfunction and suicidal ideation. The entire healthcare team bore the brunt of the burden of screening for erectile dysfunction, depression and suicidal ideation. This was attributed to the link between these diagnoses, which was, compounded in patients with prostate cancer. The screening algorithm ought to aid in guiding timely and appropriate psychiatric referral. This would optimize outcomes in such high-risk patients.

Methods

  • This study re-analyzed the current literature with regard to prostate cancer and depression, and prostate cancer and suicide.
  • It correlated the erectile dysfunction and depression.

Results

  • White, unmarried, elderly, and men with distant disease were the individuals with prostate cancer at increased risk for suicidal death.
  • Time since diagnosis was significant, since men were at risk of suicide >15 years after diagnosis.
  • Mental health distress was reported in nearly 60% of men with prostate cancer, with 10%-40% exhibiting clinically significant depression.
  • Patients that received androgen deprivation therapy (ADT) exhibited 23% more tendency to develop depression compared to those without ADT.
  • The erectile dysfunction after curative treatment could exert a considerable psychological impact, thereby causing depression.
  • A newly proposed screening algorithm recommended an analysis with the expanded prostate cancer index composite-clinical practice, patient health questionnaire-9, and an 8-question suicidal ideation questionnaire.
  • The intent was to examine for health-related quality of life, depression, and suicidal ideation.

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