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Racial Disparities in Diagnosis and Treatment of Depression Associated with Androgen Deprivation Therapy for Prostate
Asher L Mandel1, Rishabh K Simhal2, Yash B Shah3
1Lewis Katz School of Medicine at Temple University, Philadelphia, PA.
Urology
|February 23, 2024
Summary
Androgen deprivation therapy increases depression risk. White patients are more likely to be diagnosed and treated for depression than Black patients, indicating racial disparities in care.
Area of Science:
- Oncology
- Psychiatry
- Health Disparities
Background:
- Androgen deprivation therapy (ADT) is a cornerstone treatment for prostate cancer.
- Depression is a known side effect of ADT, impacting patient quality of life.
- Racial disparities in healthcare are well-documented, but their impact on ADT-associated depression is less understood.
Purpose of the Study:
- To investigate potential racial disparities in the diagnosis and management of depression among prostate cancer patients receiving ADT.
- To compare the rates of depression diagnosis and treatment between White and Black patients undergoing ADT.
Main Methods:
- A retrospective analysis of the TriNetX electronic health record network was conducted.
- Data from 78,313 prostate cancer patients treated with ADT between 2003 and 2023 were analyzed.
- Statistical comparisons of depression diagnosis and antidepressant treatment rates between racial groups were performed using odds ratios and confidence intervals.
Main Results:
- Patients on ADT had a 60% increased likelihood of developing depression compared to controls.
- Only 35% of patients with ADT-associated depression received antidepressant treatment.
- White patients had higher odds of depression diagnosis (OR 1.3) and antidepressant treatment (OR 1.4) compared to Black patients.
Conclusions:
- ADT is significantly associated with an increased risk of clinical depression, which is frequently undertreated.
- Significant racial disparities exist in both the identification and treatment of depression in patients receiving ADT.
- Implementing routine screening for depression, considering social determinants of health, may help reduce these disparities.
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