Actual change in anxiety and depression among Australian men with prostate cancer

Background: The clinical significance of anxiety and depression in prostate cancer patients remains largely unclear. In particular, the importance of somatic symptoms and their change over time has been largely unaddressed in spite of their immediate relevance to an understanding of these psychosocial aspects of prostate cancer and its treatment. Methods: Self-reports of current and previous states of anxiety and depression were collected from 183 Australian men with prostate cancer between 9 and 71 months (average=1 year 10 months) after initial diagnosis. An 'Actual Change' methodology was used to overcome the effects of extraneous sources of invalidity. Statistical tests of the total scores and specific item-changes over time were conducted. Results: Mean anxiety and depression levels reduced from time of diagnosis to time of the survey, with the most prominent changes being associated with reductions in psychomotor agitation, weakness, fatigue and pessimism. Clinically significant anxiety reduced from about 20% to 12%; clinical depression reduced from about 24% to 12.5%. Conclusion: While many prostate patients reported anxiety and depression at the time of receiving their diagnosis, about half of those for whom these disorders were of clinical significance had lowered their symptomatology 2 years later. Assessment of somatic symptoms remains a key indicator of depression and anxiety among this patient group.