title: Anxiety and depression in long-term testicular germ cell tumor survivors.
abstract: OBJECTIVE
  Despite a good prognosis, the typically young age at diagnosis and physical sequelae may cause psychological distress in germ cell tumor survivors. We aimed to determine the frequency of anxiety and depression and analyze the impact of demographic and disease-related factors.
  
  
  METHODS
  We enrolled N=164 testicular germ cell tumor survivors receiving routine follow-up care at the University Cancer Center Hamburg and a specialized private practice (mean, 11.6 years after diagnosis). Patients completed the Generalized Anxiety Disorder Screener-7, the Patient Health Questionnaire-9 and the Memorial Symptom Assessment Scale-Short Form.
  
  
  RESULTS
  We found clinically significant anxiety present in 6.1% and depression present in 7.9% of survivors. A higher number of physical symptoms and having children were significantly associated with higher levels of both anxiety and depression in multivariate regression analyses controlling for age at diagnosis, cohabitation, socioeconomic status, time since diagnosis, metastatic disease and relapse. Younger age at diagnosis and shorter time since diagnosis were significantly associated with higher anxiety.
  
  
  CONCLUSIONS
  Although rates of clinically relevant anxiety and depression were comparably low, attention toward persisting physical symptoms and psychosocial needs related to a young age at diagnosis and having children will contribute to address potential long-term psychological distress in germ cell tumor survivors.
authors.affiliation: Department of Medical Psychology, University Medical Center Hamburg, Eppendorf, Hamburg, Germany. Electronic address: s.vehling@uke.de.
authors.forename: S
authors.initials: S
authors.lastname: Vehling
authors.affiliation: Department of Medical Psychology, University Medical Center Hamburg, Eppendorf, Hamburg, Germany; Department of Medical Psychology and Medical Sociology, Division of Psychosocial Oncology, University Medical Center Leipzig, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Mehnert
authors.affiliation: Department of Urology, University Medical Center Hamburg, Eppendorf, Hamburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Hartmann
authors.affiliation: Department of Oncology, Hematology and Bone Marrow Transplantation with section of Pneumology, University Medical Center Hamburg, Eppendorf, Hamburg, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Oing
authors.affiliation: Department of Oncology, Hematology and Bone Marrow Transplantation with section of Pneumology, University Medical Center Hamburg, Eppendorf, Hamburg, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Bokemeyer
authors.affiliation: Department of Oncology, Hematology and Bone Marrow Transplantation with section of Pneumology, University Medical Center Hamburg, Eppendorf, Hamburg, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Oechsle
mesh_terms: D000328:Adult; D000367:Age Factors; D001007:Anxiety / Q000523:psychology*; D001008:Anxiety Disorders / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology*; D003865:Major Depressive Disorder / Q000523:psychology*; D005191:Family Characteristics; D005220:Fathers / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009373:Neoplasms, Germ Cell and Embryonal / Q000523:psychology*; D012044:Regression Analysis; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D013736:Testicular Neoplasms / Q000523:psychology*
keywords: Anxiety; Depression; Psychological distress; Survivorship; Testicular cancer