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PMID- 28803700
OWN - NLM
STAT- In-Process
LR  - 20171022
IS  - 1873-2496 (Electronic)
IS  - 1078-1439 (Linking)
VI  - 35
IP  - 11
DP  - 2017 Nov
TI  - Association of androgen deprivation therapy and depression in the treatment of
      prostate cancer: A systematic review and meta-analysis.
PG  - 664.e1-664.e9
LID - S1078-1439(17)30378-2 [pii]
LID - 10.1016/j.urolonc.2017.07.016 [doi]
AB  - BACKGROUND: There is increasing evidence that androgen deprivation therapy (ADT) 
      may be associated with depression. Existing studies have shown conflicting
      results. METHODS: PubMed, Web of Science, Embase, and PsycINFO were queried on
      April 5, 2017. Eligible studies were in English and reported depression among
      individuals with prostate cancer exposed to a course of ADT vs. a lesser-exposed 
      group (e.g., any-ADT vs. no ADT and continuous ADT vs. intermittent ADT). We used
      the MOOSE statement guidelines and the Cochrane Review Group's data extraction
      template. Study quality was evaluated by Newcastle-Ottawa Scale criteria. We
      conducted a random-effects meta-analysis to calculate summary statistic risk
      ratios (RRs) and 95% CIs. Heterogeneity was quantified using the I(2) statistic
      and prespecified subgroup analysis. Small study effects were evaluated using Begg
      and Egger statistics. RESULTS: A total of 1,128 studies were initially identified
      and evaluated. A meta-analysis of 18 studies among 168,756 individuals found that
      ADT use conferred a 41% increased risk of depression (RR = 1.41; 95% CI:
      1.18-1.70; P<0.001). We found a consistent strong statistically significant
      association when limiting our analysis to studies in localized disease (RR =
      1.85; 95% CI: 1.20-2.85; P = 0.005) and those using a clinical diagnosis of
      depression (RR = 1.19; 95% CI: 1.08-1.32; P = 0.001). We did not find an
      association for continuous ADT with depression risk compared to intermittent ADT 
      (RR = 1.00; 95% CI: 0.50-1.99; P = 0.992). There was no statistically significant
      evidence of small study effects. Statistically significant heterogeneity in the
      full analysis (I(2) = 80%; 95% CI: 69-87; P<0.001) resolved when examining
      studies using a clinical diagnosis of depression (I(2) = 16%; 95% CI: 0-60; P =
      0.310). CONCLUSION: The currently available evidence suggests that ADT in the
      treatment of prostate cancer is associated with an increased risk of depression.
CI  - Copyright (c) 2017 Elsevier Inc. All rights reserved.
FAU - Nead, Kevin T
AU  - Nead KT
AD  - Department of Radiation Oncology, Perelman School of Medicine, Perelman Center
      for Advanced Medicine, University of Pennsylvania, Philadelphia, PA. Electronic
      address: [email protected]
FAU - Sinha, Sumi
AU  - Sinha S
AD  - Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and
      Women's Hospital, Harvard Medical School, Boston, MA.
FAU - Yang, David D
AU  - Yang DD
AD  - Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and
      Women's Hospital, Harvard Medical School, Boston, MA.
FAU - Nguyen, Paul L
AU  - Nguyen PL
AD  - Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and
      Women's Hospital, Harvard Medical School, Boston, MA.
LA  - eng
PT  - Journal Article
DEP - 20170810
PL  - United States
TA  - Urol Oncol
JT  - Urologic oncology
JID - 9805460
OTO - NOTNLM
OT  - Androgen deprivation therapy
OT  - Behavioral symptoms
OT  - Depression
OT  - Hormone therapy
OT  - Prostate cancer
EDAT- 2017/08/15 06:00
MHDA- 2017/08/15 06:00
CRDT- 2017/08/15 06:00
PHST- 2017/04/06 00:00 [received]
PHST- 2017/07/05 00:00 [revised]
PHST- 2017/07/17 00:00 [accepted]
PHST- 2017/08/15 06:00 [pubmed]
PHST- 2017/08/15 06:00 [medline]
PHST- 2017/08/15 06:00 [entrez]
AID - S1078-1439(17)30378-2 [pii]
AID - 10.1016/j.urolonc.2017.07.016 [doi]
PST - ppublish
SO  - Urol Oncol. 2017 Nov;35(11):664.e1-664.e9. doi: 10.1016/j.urolonc.2017.07.016.
      Epub 2017 Aug 10.