title: Psychological distress and adjustment to disease in patients before and after radical prostatectomy. Results of a prospective multi-centre study.
abstract: The aim of this prospective multi-centre study was to evaluate the level of psychological distress (PD) and adjustment to disease in patients who underwent radical prostatectomy. Furthermore, the impact of urinary incontinence and erectile dysfunction on PD was assessed. Anxiety, depression and PD were evaluated using the Hospital Anxiety and Depression Scale in 329 prostate cancer patients before surgery as well as 3, 6 and 12 months after surgery. These results were compared with those of a male German general population reference group. Adjustment to disease was assessed using the Perceived Adjustment to Chronic Illness Scale. Patients reported low levels of PD at all points of assessment similar to population norms of age-matched German men. Persistent PD was seen in about 8% of the patients and 20% had PD at least two of the measurement points. Relevant predictors for PD after surgery were urinary symptoms and baseline PD. Adjustment to disease was highest before surgery and had significantly reduced at 3 and 6 months after surgery. In general, men are resilient to the experience of localised prostate cancer and adjust well psychologically after surgery. However, between 8% and 20% of patients could possibly benefit from mental health support.
authors.affiliation: Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Köhler
authors.forename: M
authors.initials: M
authors.lastname: Friedrich
authors.forename: L
authors.initials: L
authors.lastname: Gansera
authors.forename: S
authors.initials: S
authors.lastname: Holze
authors.forename: R
authors.initials: R
authors.lastname: Thiel
authors.forename: S
authors.initials: S
authors.lastname: Roth
authors.forename: U
authors.initials: U
authors.lastname: Rebmann
authors.forename: J-U
authors.initials: JU
authors.lastname: Stolzenburg
authors.forename: M C
authors.initials: MC
authors.lastname: Truss
authors.forename: D
authors.initials: D
authors.lastname: Fahlenkamp
authors.forename: H-J
authors.initials: HJ
authors.lastname: Scholz
authors.forename: E
authors.initials: E
authors.lastname: Brähler
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000704:Analysis of Variance; D001007:Anxiety / Q000453:epidemiology / Q000209:etiology; D016022:Case-Control Studies; D003866:Depressive Disorder / Q000453:epidemiology / Q000209:etiology; D007172:Erectile Dysfunction / Q000209:etiology / Q000523:psychology; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011468:Prostatectomy / Q000523:psychology*; D011471:Prostatic Neoplasms / Q000150:complications / Q000523:psychology* / Q000601:surgery; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012307:Risk Factors; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology*; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000209:etiology / Q000523:psychology
keywords: emotional; prostate cancer; psychological; supportive care