title: Pretreatment depressive symptoms and treatment modality predict post-treatment disease-specific quality of life among patients with localized prostate cancer.
abstract: OBJECTIVE
  This study examines the prevalence of depressive symptoms before prostate cancer treatment and explores associations among pre-treatment depressive symptoms and post-treatment disease-specific QOL, controlling for treatment modality, and demographic and clinical covariates.
  
  
  METHODS
  A case series of patients diagnosed with localized prostate cancer (T1-2N0M0) at a comprehensive cancer center was assessed. Of the 1,370 eligible patients, 869 (63.34%) completed questionnaires at diagnosis (baseline) and 6 months following treatment. Patients were treated with surgery (16.8%), brachytherapy (27.6%), or external beam radiation (EBRT; 55.6%). Depressive symptoms and disease-specific QOL were assessed with established measures (i.e., Center for Epidemiologic Studies Depression Scale (CES-D); sexual adjustment questionnaire (SAQ); and the American Urological Association symptom index).
  
  
  RESULTS
  A fifth of the sample (19.7%) reported clinically elevated levels of depressive symptoms at baseline. The proportion of clinically elevated levels of baseline depressive symptoms was higher among surgery patients compared with patients treated with brachytherapy or external beam radiation. Depressive symptoms at baseline and treatment modality significantly predicted sexual and urinary dysfunction, related bother, activity limitation due to urinary dysfunction at 6 months, controlling for, age, PSA level, Gleason score, relevant baseline indicators of sexual and urinary dysfunction, related bother, and activity limitation (P < 0.05).
  
  
  CONCLUSIONS
  Pretreatment depressive symptoms and treatment modality predict QOL after PrCa treatment. Health care providers should be sensitive to the display of depressive symptoms before PrCa treatment and consider preventative interventions, including preparing patients for the changes in disease-specific QOL and related bother following prostate cancer treatment.
authors.affiliation: Department of Urology, Mount Sinai School of Medicine, New York, NY 10029, USA. Nihal.Mohamed@mountsinai.org
authors.forename: Nihal E
authors.initials: NE
authors.lastname: Mohamed
authors.forename: Dana H
authors.initials: DH
authors.lastname: Bovbjerg
authors.forename: Guy H
authors.initials: GH
authors.lastname: Montgomery
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Hall
authors.forename: Michael A
authors.initials: MA
authors.lastname: Diefenbach
mesh_terms: D000368:Aged; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D015995:Prevalence; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000473:pathology / Q000523:psychology* / Q000628:therapy*; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires
chemical_list: D017430:Prostate-Specific Antigen