Psychological morbidity following prostate cancer diagnosis and treatment

Prostate cancer is the most prevalent cancer and second leading cause of cancer-related deaths among men. The purpose of this study is to see if receiving a diagnosis of prostate cancer leads to an increased incidence of psychiatric diagnoses including acute stress disorder (ASD) and posttraumatic stress disorder (PTSD). First, 58 men who were recently diagnosed with prostate cancer (PC) were compared to a group of 25 men with a more benign gerito-urinary disease, Benign Prostatic Hypertrophy (BPH) on psychological and psychosocial functioning. Secondly, the PC patients were prospectively followed up on these domains until their cancer treatment was complete. Both groups of men received a structured clinical interview assessing for current and lifetime diagnoses of ASD, PTSD, major depressive disorder (MDD), generalized anxiety disorder (GAD), substance abuse/dependence and the Life Base Psychosocial Schedule Interview. Both groups also completed the Stanford Acute Stress Reaction Questionnaire, PTSD Checklist, Brief Symptom Inventory and UCLA Prostate Cancer Index. Following the cancer diagnosis 20.7% (n = 12) of PC patients met criteria for subsyndromal or full ASD and 13.6% (n = 3 out of 22 participants) met criteria for PTSD. Post-diagnosis 8.6% (n = 5) of the PC patients met criteria for MDD. None of the BPH patients were positive for these disorders. The differences between the rate of subsyndromal or full ASD and subsyndromal or full PTSD between the two groups were statistically significant (p < 0.05). PC patients showed higher distress from PTSD symptoms and worse global functioning compared to the BPH patients. The following variables significantly predicted PTSD symptom severity and presence of PTSD: previous traumatic events, stage of cancer at diagnosis and previous episode of major depression. The incidence of ASD and PTSD was highest following the diagnosis and two weeks later but the rate of PTSD significantly dropped at the post-treatment assessment. At the post-treatment assessment the PC patients reported a significant decline in physical functioning, role physical/role limitation physical, urinary functioning and sexual functioning. However, they showed a significant improvement in anxiety, overall psychological distress and global functioning. Following the cancer diagnosis PC patients exhibited the highest rate of ASD and PTSD which significantly remitted post-treatment.