Study of anxiety disorder and depression in long-term survivors of testicular cancer

Purpose To increase our knowledge of the prevalence of anxiety disorder and depression in long-term testicular cancer survivors (TCSs), and to identify variables associated with such caseness. Patients and Methods Participants were 1,408 TCSs treated between 1980 and 1994 in Norway. Participants provided information about their medical, social, and familial situation on a questionnaire. They also completed the Hospital Anxiety and Depression Scale (HADS). Anxiety disorder and depression were defined by a score >= 8 on the HADS subscales. The prevalence rates were compared with age-adjusted norm data. Results HADS-defined anxiety disorder was more prevalent in TCSs (19.2%; 95% Cl, 17.2% to 21.3%)than in the norm sample (13.5%; 95% Cl, 13.1% to 13.9%; P <.001), whereas the prevalence of HADS-defined depression did not differ from the norm (TCSs, 9.7%; 95% Cl, 8.1 % to 11.2% v norm, 10.1 %, 95% Cl, 9.5 to 10.5; P =.56). The relative risk for anxiety disorder was 1.49 (95% Cl, 1.31 to 1.69) and for depression the relative risk was 0.96 (95% Cl, 0.81 to1.14) in TCSs compared with norm. In multivariate analyses, HADS-defined anxiety disorder in TCSs was associated with young age, peripheral neuropathy, economic problems, alcohol problems, sexual problems, relapse anxiety, and having been treated for mental problems. Conclusion Long-term TCSs have an increased risk of HADS-defined anxiety disorder that warrants clinical attention. Checking easily available demographic and TC-related data and use of a simple screening test such as HADS assists the identification of TCSs with anxiety disorder.