Psychiatric treatment in men with prostate cancer – Results from a Nation-wide, population-based cohort study from PCBaSe Sweden Anna Bill-Axelson a,b, * , Hans Garmo c,d , Ullakarin Nyberg b,e , Mats Lambe c,f , Ola Bratt g , Pa ¨ r Stattin h , Jan Adolfsson i , Gunnar Steineck b,j a Department of Urology, University Hospital, Uppsala, Sweden b Department of Clinical Cancer Epidemiology, Karolinska Institutet, Stockholm, Sweden c Regional Oncologic Center, University Hospital, Uppsala, Sweden d King’s College London, School of Medicine, Division of Cancer Studies, London, UK e Department of Clinical Neuroscience, Section of Psychiatry St. Go ¨ran, Karolinska Institutet, Stockholm, Sweden f Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden g Department of Urology, Hospital of Helsingborg, Lund University, Helsingborg, Sweden h Department of Surgical and Perioperative Sciences, Urology and Andrology, Umea ˚ University, Umea ˚ , Sweden i Oncological Center, CLINTEC Department, Karolinska Institutet, Stockholm, Sweden j Division of Clinical Cancer Epidemiology, The Sahlgrenska Academy, Gothenburg, Sweden ARTICLE INFO Article history: Available online 24 May 2011 Keywords: Prostate cancer Depression Anxiety post-traumatic stress disorder Androgen deprivation therapy Cohort study Population-based ABSTRACT Aim: To explore whether the self-reported psychological distress among men with prostate cancer was to the extent that it required psychiatric treatment. Methods: PCBaSe Sweden, a merged database based on the National Prostate Cancer Regis- ter including 97% of all prostate cancers registered as well as age-matched controls. We cal- culated relative risks and 95% confidence intervals to compare risks of psychiatric treatment due to depression, anxiety, and post-traumatic stress disorder controlling for age and socio-economic factors. We used odds ratios to compare use or no use of antide- pressants. Findings: In total 72,613 men with prostate cancer and 217,839 men without prostate cancer were included for analyses. Psychiatric hospitalisation due to depression, anxiety and post- traumatic stress disorder were significantly increased (RR 1.29, (95% CI 1.14–1.45), RR 1.42 (95% CI 1.12–1.80) and RR 1.61 (95% CI 1.16–2.24), respectively). However, hospitalisations due to anxiety were only increased in men with more advanced tumours RR 2.28 (95% CI 1.45–3.57). The use of antidepressants was increased for all men with prostate cancer RR 1.65 (95% CI 1.54–1.77) and treatment strategies RR 1.93 (95% CI 1.75–2.13). Interpretation: Men diagnosed with prostate cancer had increased risk of psychiatric treat- ment for depression, post-traumatic stress disorder and use of antidepressants regardless of risk group and treatment strategy compared to age-matched controls, whilst more advanced prostate cancer was associated with severe anxiety disorders. Ó 2011 Elsevier Ltd. All rights reserved. 0959-8049/$ - see front matter Ó 2011 Elsevier Ltd. All rights reserved. doi:10.1016/j.ejca.2011.04.022 * Corresponding author: Address: Department of Urology, University Hospital, SE-751 85 Uppsala, Sweden. Tel.: +46 18 611 46 60, +46 70 532 32 12; fax: +46 18 55 91 59. E-mail addresses: anna.bill.axelson@akademiska.se, anna.billax@telia.com (A. Bill-Axelson). EUROPEAN JOURNAL OF CANCER 47 (2011) 2195 – 2201 available at www.sciencedirect.com journal homepage: www.ejconline.com