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

Zachary Klaassen, Karan Arora, Shenelle N. Wilson, Sherita A. King, Rabii Madi, Durwood E. Neal, Paul Kurdyak, Girish S. Kulkarni, Ronald W. Lewis, Martha K. Terris

Research output: Contribution to journalReview article

14 Citations (Scopus)

Abstract

Objective: Prostate cancer is the most common malignancy among males, accounting for 19% of cancers, and the third most common cancer-related cause of death. Suicide rates in the United States have increased among males over the last decade. Further, suicide rates are higher in oncology patients, including patients with prostate cancer, compared to the general population. The objective of this article is to review the current literature and address the relationship between prostate cancer, depression, erectile dysfunction, and suicidal ideation. Materials and methods: We reviewed the current literature pertaining to prostate cancer and depression, and prostate cancer and suicide. Furthermore, associations were made between erectile dysfunction and depression. Results: Men with prostate cancer at increased risk for suicidal death are White, unmarried, elderly, and men with distant disease. Time since diagnosis is also an important factor, since men are at risk of suicide>15 years after diagnosis. Approximately 60% of men with prostate cancer experience mental health distress, with 10%–40% having clinically significant depression. Additionally, patients that received androgen deprivation therapy (ADT) are 23% more likely to develop depression compared to those without ADT. Longitudinal studies of prostate cancer patients suggest that erectile dysfunction after curative treatment may have a significant psychological effect leading to depression. Herein, a newly proposed screening algorithm suggests for an evaluation with the expanded prostate cancer index composite-clinical practice, patient health questionnaire-9, and an 8-question suicidal ideation questionnaire to assess for health-related quality of life, depression, and suicidal ideation. Conclusion: The burden of screening for erectile dysfunction, depression and suicidal ideation lies with the entire health care team, as there appears to be an association between these diagnoses, that is, compounded in patients with prostate cancer. The screening algorithm should assist with guiding timely and appropriate psychiatric referral to optimize outcomes in these high-risk patients.

Original languageEnglish (US)
Pages (from-to)60-66
Number of pages7
JournalUrologic Oncology: Seminars and Original Investigations
Volume36
Issue number2
DOIs
StatePublished - Feb 2018

Fingerprint

Suicidal Ideation
Erectile Dysfunction
Suicide
Prostatic Neoplasms
Depression
Androgens
Neoplasms
Patient Care Team
Psychiatry
Longitudinal Studies
Cause of Death
Mental Health
Therapeutics
Referral and Consultation
Quality of Life
Psychology

Keywords

  • Depression
  • Erectile dysfunction
  • Prostate cancer
  • Quality of life
  • Suicidal ideation
  • Suicide
  • Survivorship

ASJC Scopus subject areas

  • Oncology
  • Urology

Cite this

Decreasing suicide risk among patients with prostate cancer : Implications for depression, erectile dysfunction, and suicidal ideation screening. / Klaassen, Zachary; Arora, Karan; Wilson, Shenelle N.; King, Sherita A.; Madi, Rabii; Neal, Durwood E.; Kurdyak, Paul; Kulkarni, Girish S.; Lewis, Ronald W.; Terris, Martha K.

In: Urologic Oncology: Seminars and Original Investigations, Vol. 36, No. 2, 02.2018, p. 60-66.

Research output: Contribution to journalReview article

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abstract = "Objective: Prostate cancer is the most common malignancy among males, accounting for 19{\%} of cancers, and the third most common cancer-related cause of death. Suicide rates in the United States have increased among males over the last decade. Further, suicide rates are higher in oncology patients, including patients with prostate cancer, compared to the general population. The objective of this article is to review the current literature and address the relationship between prostate cancer, depression, erectile dysfunction, and suicidal ideation. Materials and methods: We reviewed the current literature pertaining to prostate cancer and depression, and prostate cancer and suicide. Furthermore, associations were made between erectile dysfunction and depression. Results: Men with prostate cancer at increased risk for suicidal death are White, unmarried, elderly, and men with distant disease. Time since diagnosis is also an important factor, since men are at risk of suicide>15 years after diagnosis. Approximately 60{\%} of men with prostate cancer experience mental health distress, with 10{\%}–40{\%} having clinically significant depression. Additionally, patients that received androgen deprivation therapy (ADT) are 23{\%} more likely to develop depression compared to those without ADT. Longitudinal studies of prostate cancer patients suggest that erectile dysfunction after curative treatment may have a significant psychological effect leading to depression. Herein, a newly proposed screening algorithm suggests for an evaluation with the expanded prostate cancer index composite-clinical practice, patient health questionnaire-9, and an 8-question suicidal ideation questionnaire to assess for health-related quality of life, depression, and suicidal ideation. Conclusion: The burden of screening for erectile dysfunction, depression and suicidal ideation lies with the entire health care team, as there appears to be an association between these diagnoses, that is, compounded in patients with prostate cancer. The screening algorithm should assist with guiding timely and appropriate psychiatric referral to optimize outcomes in these high-risk patients.",
keywords = "Depression, Erectile dysfunction, Prostate cancer, Quality of life, Suicidal ideation, Suicide, Survivorship",
author = "Zachary Klaassen and Karan Arora and Wilson, {Shenelle N.} and King, {Sherita A.} and Rabii Madi and Neal, {Durwood E.} and Paul Kurdyak and Kulkarni, {Girish S.} and Lewis, {Ronald W.} and Terris, {Martha K.}",
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T1 - Decreasing suicide risk among patients with prostate cancer

T2 - Implications for depression, erectile dysfunction, and suicidal ideation screening

AU - Klaassen, Zachary

AU - Arora, Karan

AU - Wilson, Shenelle N.

AU - King, Sherita A.

AU - Madi, Rabii

AU - Neal, Durwood E.

AU - Kurdyak, Paul

AU - Kulkarni, Girish S.

AU - Lewis, Ronald W.

AU - Terris, Martha K.

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N2 - Objective: Prostate cancer is the most common malignancy among males, accounting for 19% of cancers, and the third most common cancer-related cause of death. Suicide rates in the United States have increased among males over the last decade. Further, suicide rates are higher in oncology patients, including patients with prostate cancer, compared to the general population. The objective of this article is to review the current literature and address the relationship between prostate cancer, depression, erectile dysfunction, and suicidal ideation. Materials and methods: We reviewed the current literature pertaining to prostate cancer and depression, and prostate cancer and suicide. Furthermore, associations were made between erectile dysfunction and depression. Results: Men with prostate cancer at increased risk for suicidal death are White, unmarried, elderly, and men with distant disease. Time since diagnosis is also an important factor, since men are at risk of suicide>15 years after diagnosis. Approximately 60% of men with prostate cancer experience mental health distress, with 10%–40% having clinically significant depression. Additionally, patients that received androgen deprivation therapy (ADT) are 23% more likely to develop depression compared to those without ADT. Longitudinal studies of prostate cancer patients suggest that erectile dysfunction after curative treatment may have a significant psychological effect leading to depression. Herein, a newly proposed screening algorithm suggests for an evaluation with the expanded prostate cancer index composite-clinical practice, patient health questionnaire-9, and an 8-question suicidal ideation questionnaire to assess for health-related quality of life, depression, and suicidal ideation. Conclusion: The burden of screening for erectile dysfunction, depression and suicidal ideation lies with the entire health care team, as there appears to be an association between these diagnoses, that is, compounded in patients with prostate cancer. The screening algorithm should assist with guiding timely and appropriate psychiatric referral to optimize outcomes in these high-risk patients.

AB - Objective: Prostate cancer is the most common malignancy among males, accounting for 19% of cancers, and the third most common cancer-related cause of death. Suicide rates in the United States have increased among males over the last decade. Further, suicide rates are higher in oncology patients, including patients with prostate cancer, compared to the general population. The objective of this article is to review the current literature and address the relationship between prostate cancer, depression, erectile dysfunction, and suicidal ideation. Materials and methods: We reviewed the current literature pertaining to prostate cancer and depression, and prostate cancer and suicide. Furthermore, associations were made between erectile dysfunction and depression. Results: Men with prostate cancer at increased risk for suicidal death are White, unmarried, elderly, and men with distant disease. Time since diagnosis is also an important factor, since men are at risk of suicide>15 years after diagnosis. Approximately 60% of men with prostate cancer experience mental health distress, with 10%–40% having clinically significant depression. Additionally, patients that received androgen deprivation therapy (ADT) are 23% more likely to develop depression compared to those without ADT. Longitudinal studies of prostate cancer patients suggest that erectile dysfunction after curative treatment may have a significant psychological effect leading to depression. Herein, a newly proposed screening algorithm suggests for an evaluation with the expanded prostate cancer index composite-clinical practice, patient health questionnaire-9, and an 8-question suicidal ideation questionnaire to assess for health-related quality of life, depression, and suicidal ideation. Conclusion: The burden of screening for erectile dysfunction, depression and suicidal ideation lies with the entire health care team, as there appears to be an association between these diagnoses, that is, compounded in patients with prostate cancer. The screening algorithm should assist with guiding timely and appropriate psychiatric referral to optimize outcomes in these high-risk patients.

KW - Depression

KW - Erectile dysfunction

KW - Prostate cancer

KW - Quality of life

KW - Suicidal ideation

KW - Suicide

KW - Survivorship

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