Implications of Mental Health Illness on Outcomes of Prostate Cancer Patients in the Veterans Affairs Medical System
Abstract
Purpose: To determine whether mental health illness (MHI) impacts risk of prostate cancer (PC) diagnosis and aggressiveness; to explore whether MHI prior to PC diagnosis (i) impacts treatment received, (ii) adherence to guideline-specific follow-up, (iii) PC-specific outcomes, and whether (iv) MHI-specific therapy improves PC outcomes among those with MHI. Scope: PC is the most common malignancy diagnosed in the VA system, making up 29 percent of oncology diagnoses. Secondary to the proportion of older men and African Americans served, a disproportionate burden of PC is placed on the VA system. Specific to the VA, across-sectional evaluation of 4,461,208 veterans seen in Patient Aligned Care Teams noted that 25.7 percent had at least one diagnosis of depression, PTSD, substance abuse disorder, anxiety disorder or serious mental illness. Many men with PC will be treated (and cured) of their disease. However, 60 percent of men with PC experience mental health distress, with 10-40 percent having clinically significant depression. We have previously demonstrated that PC patients are significantly at risk of suicidal death even up to 15 years after diagnosis. Considering this and the paucity of studies in the VA system assessing the relationship between PC and MHI, our intention is to explore several MHI/PC aims using the nationwide VA health database. Major Findings: To date, in line with the revised Statement of Work, we have completed the Standard Operation Procedures (SOP) document for building this database assessing the impact of MHI on PC in the national VA dataset. This included twice-monthly remote meetings (secondary to the COVID-19 pandemic) with the research team to finalize the SOP, which included finalizing variable and outcome operationalization. Towards the end of finalizing the SOP, we had several meetings with co-mentor Dr. Jean Beckham, noted PTSD and psychiatric expert, to ensure clear delineation of MHI specific pharmacotherapy and psychotherapy.
Document Details
- Document Type
- Technical Report
- Publication Date
- Mar 01, 2021
- Accession Number
- AD1136215
Entities
People
- Zachary Klaassen
Organizations
- Augusta University