title: Predictors of depression, anxiety and quality of life in patients with prostate cancer receiving androgen deprivation therapy.
abstract: OBJECTIVE
  To evaluate the effects of androgen deprivation therapy (ADT) on depression, anxiety and quality of life (QoL) in patients with prostate cancer (PCa) and to examine the relationship between meeting the National Physical Activity Guidelines of Australia (NPAGA) and the presence and severity of both psychological sequelae and physical side effects associated with ADT. A secondary purpose was to examine the predictors of depression, anxiety and QoL in patients with PCa.
  
  
  METHODS
  A questionnaire was mailed to English-speaking patients aged 40 to 80 years, who had received radiotherapy for PCa during 2010 and 2011, between 9 and 30 months prior to study initiation. Measures included the following: the International Physical Activity Questionnaire; the Hospital Anxiety and Depression Scale; the Functional Assessment of Cancer Therapy-Prostate; and sociodemographic items.
  
  
  RESULTS
  Long-term use of ADT was associated with poorer QoL and psychosocial well-being. Those meeting NPAGA had significantly lower levels of depression and anxiety and improved QoL compared with those not meeting NPAGA. Logistic regression analyses showed the odds of clinically significant depression and anxiety scores, increased with younger age and comorbid conditions. Not meeting NPAGA increased the likelihood of caseness for depression. Multiple regression analyses revealed that comorbid conditions and treatment category predicted poorer QoL, whereas meeting NPAGA positively predicted QoL.
  
  
  CONCLUSIONS
  The use of ADT in the management of patients with PCa has a measurable effect on QoL. These findings support the utility of physical activity as an intervention for men undergoing ADT.
authors.affiliation: School of Psychology and Psychiatry, Monash University, Melbourne, Australia.
authors.forename: Kelly
authors.initials: K
authors.lastname: Chipperfield
authors.affiliation: School of Psychology and Psychiatry, Monash University, Melbourne, Australia.|Cabrini Monash Psycho-Oncology, Cabrini Institute, Cabrini, Melbourne, Australia.
authors.forename: Jane
authors.initials: J
authors.lastname: Fletcher
authors.affiliation: William Buckland Radiotherapy Centre, The Alfred Hospital, Melbourne, Australia.|Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Millar
authors.affiliation: School of Psychology and Psychiatry, Monash University, Melbourne, Australia.|Cabrini Monash Psycho-Oncology, Cabrini Institute, Cabrini, Melbourne, Australia.
authors.forename: Joanne
authors.initials: J
authors.lastname: Brooker
authors.affiliation: William Buckland Radiotherapy Centre, The Alfred Hospital, Melbourne, Australia.
authors.forename: Robin
authors.initials: R
authors.lastname: Smith
authors.affiliation: Department of Surgery, Monash University, Melbourne, Australia.|Department of Urology, Monash Medical Centre, Southern Health, Melbourne, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Frydenberg
authors.affiliation: School of Psychology and Psychiatry, Monash University, Melbourne, Australia.|Cabrini Monash Psycho-Oncology, Cabrini Institute, Cabrini, Melbourne, Australia.
authors.forename: Sue
authors.initials: S
authors.lastname: Burney
mesh_terms: D000367:Age Factors; D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use*; D001007:Anxiety / Q000523:psychology*; D001315:Australia; D001918:Brachytherapy; D015897:Comorbidity; D003863:Depression / Q000523:psychology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000523:psychology* / Q000628:therapy; D011788:Quality of Life; D011878:Radiotherapy; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D000726:Androgen Antagonists
keywords: Oncology; anxiety; depression; physical activity; prostate cancer; quality of life