Depression and anxiety in prostate cancer: a systematic review and meta-analysis of prevalence rates

Sam Watts, Geraldine Leydon, Brian Birch, Philip Prescott, Lily Lai, Susan Eardley, George Lewith Author Affiliations : Primary Care & Population Sciences, University of Southampton, Southampton, Hampshire, UK Department of Urology, Southampton University Hospitals NHS Trust, Southampton, Hampshire, UK Department of Mathematics, University of Southampton, Southampton, Hampshire, UK

Abstract
Objectives to systematically review the literature pertaining to the prevalence of depression and anxiety in patients with prostate cancer as a function of treatment stage.

Design
Systematic review and meta-analysis 

Participants
4494 patients with prostate cancer from primary research investigations

Primary outcome measure
The prevalence of clinical depression and anxiety in patients with prostate cancer as a function of treatment stage

Results
We identified 27 full journal articles that met the inclusion criteria for entry into the meta-analysis resulting in a pooled sample size of 4494 patients. The meta-analysis of prevalence rates identified pretreatment, on-treatment and post-treatment depression prevalences of 17.27% (95% CI 15.06% to 19.72%), 14.70% (95% CI 11.92% to 17.99%) and 18.44% (95% CI 15.18% to 22.22%), respectively. Pretreatment, on-treatment and post-treatment anxiety prevalences were 27.04% (95% CI 24.26% to 30.01%), 15.09% (95% CI 12.15% to 18.60%) and 18.49% (95% CI 13.81% to 24.31%), respectively.

Conclusions
Our findings suggest that the prevalence of depression and anxiety in men with prostate cancer, across the treatment spectrum, is relatively high. In light of the growing emphasis placed on cancer survivorship, we consider that further research within this area is warranted to ensure that psychological distress in patients with prostate cancer is not underdiagnosed and undertreated.

Citation:
BMJ Open 2014;4:e003901 doi:10.1136/bmjopen-2013-003901

Correspondence to
Professor George Lewith; glewith@scmrt.org.uk

Received 28 August 2013; Revised 21 January 2014; Accepted 24 January 2014; Published 13 March 2014