The effects of low- and high-dose-rate brachytherapy on depressive symptoms in prostate cancer patients

Objective: To compare the prevalence of depressive symptoms between prostate cancer (PCa) patients who have received low-dose-rate brachytherapy (LDRB) and those receiving high-dose-rate brachytherapy (HDRB).

Method: Direct comparisons were made between the prevalence of the DSM-IV-TR symptoms of major depressive disorder (MDD) based upon Zung Self-Rating Depression Scale responses and patients’ records on 164 PCa patients from Queensland, Australia.

Results: HDRB patients had significantly greater frequency of self-reported symptoms of crying (or feeling like it) (MDD criterion 1), and restlessness and inability to sit still (MDD criterion 5), and a nonsignificant trend towards more frequent fatigue (MDD criterion 7). There was no significant association between fatigue and having received hormone therapy.

Conclusion: These three MDD symptoms, which include one of the two alternative key required symptoms (criterion 1), suggest that HDRB PCa patients may present with clinically significantly different depression profiles from their peers who receive LDRB. Treatment choices need to be focused upon possible serotonergic dysfunction as well as somatic complaints of depression. The presence of subsyndromal depression in HDRB patients also warrants consideration.