Mental health outcomes in elderly men with prostate cancer
Mental health outcomes in elderly men with prostate cancer
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DOI：
10.1016/j.urolonc.2014.05.005
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发表时间：
2014-11-01
影响因子：
2.7
通讯作者：
Quoc-Dien Trinh
中科院分区：
文献类型：
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作者：
Ravi, Praful;Karakiewicz, Pierre I.;Quoc-Dien Trinh
目的：在一个以人群为基础的局限性前列腺癌老年男性队列中，研究心理健康问题（MHI）的负担，即焦虑、抑郁障碍和自杀，并评估与初级治疗方式的关系。患者和方法：从监测、流行病学和最终结果医疗保险数据库中抽取了50,856名年龄在65岁或以上的男性，这些男性在1992年至2005年间被诊断为临床局限性前列腺癌，并且在基线时没有精神疾病的诊断。研究的主要结局是诊断前列腺癌后Mill（焦虑、重度抑郁症、未分类的抑郁症、神经性抑郁症、抑郁情绪的适应障碍和自杀）的发展。结果：在研究期间，共有10,389名男性（20.4%）发生了MHI。MET的独立危险因素包括年龄bb0 = 75岁(风险比[HR] =。1.29);较高的合并症（Charlson共病指数>= 3,HR = 1.63）；农村医院所在地（HR = 1.14）；单身、离婚或丧偶（HR = 1.12）；诊断年份较晚（HR = 1.05）；尿失禁（HR = 1.47）。黑人（HR = 0.79）、高收入状态（HR = 0.87）和最终治疗（根治性前列腺切除术[RP]， HR = 0.79；放疗[RT]， HR = 0.85，均P < 0.001）预测MHI的风险较低。观察等待（WW）、RT和RP组10年MHI发生率分别为29.7%、29.0%和22.6%。结论：患有局限性前列腺癌的老年男性有显著的MM负担。接受RP或RT治疗的男性与接受WW治疗的男性相比，患MET的风险较低，接受RP治疗的男性与接受RT或WW治疗的男性相比，患MHI的中位时间显著大于接受RT或WW治疗的男性。(C) 2014爱思唯尔公司版权所有。
Objective: To examine the burden of mental health issues (MHI), namely anxiety, depressive disorders, and suicide, in a population-based cohort of older men with localized prostate cancer and to evaluate associations with primary treatment modality.Patients and methods: A total of 50,856 men, who were 65 years of age or older with clinically localind prostate cancer diagnosed between 1992 and 2005 and without a diagnosis of mental illness at baseline, were abstracted from the Surveillance, Epidemiology, and End Results Medicare database. The primary outcome of interest was the development of Mill (anxiety, major depressive disorder, depressive disorder not elsewhere classified, neurotic depression, adjustment disorder with depressed mood, and suicide) after the diagnosis of prostate cancer.Results: A total of 10,389 men (20.4%) developed MHI during the study period. Independent risk factors for MET included age >= 75 years (hazard ratio [HR] =. 1.29); higher comorbidity (Charlson comorbidity index >= 3, HR = 1.63); rural hospital location (HR = 1.14); being single, divorced, or widowed (HR = 1.12); later year of diagnosis (HR = 1.05); and urinary incontinence (HR = 1.47). Black race (HR = 0.79), very high-income status (HR = 0.87), and definitive treatment (radical prostatectomy [RP], HR = 0.79; radiotherapy [RT], HR = 0.85, all P < 0.001) predicted a lower risk of MHI. The rates of MHI at 10 years were 29.7%, 29.0%, and 22.6% in men undergoing watchful waiting (WW), RT, and RP, respectively.Conclusion: Older men with localized prostate cancer had a significant burden of MM. Men treated with RP or RT were at a lower risk of developing MET, compared with those undergoing WW, with median time to development of MHI being significantly greater in those undergoing RP compared with those undergoing RT or WW. (C) 2014 Elsevier Inc. All rights reserved.