Abstract
BACKGROUND: Anxiety and depression are commonly recognized and prognostically relevant in cancer patients. The aim of this study was to explore the 3-year longitudinal changes in anxiety and depression, their risk factors, and prognostic value in patients with bladder cancer. METHODS: Hospital Anxiety and Depression Scale for anxiety (HADS-A) and depression (HADS-D) scores of 120 postoperative bladder cancer patients and 100 healthy controls (HCs) were assessed. Additionally, the HADS-A and HADS-D scores of bladder cancer patients were determined at 1 year, 2 years, and 3 years post surgery. RESULTS: HADS-A score (7.7 ± 3.0 vs. 4.8 ± 2.6), anxiety rate (38.3% vs. 9.0%), HADS-D score (7.7 ± 3.3 vs. 4.3 ± 2.6), depression rate (40.0% vs. 11.0%), as well as anxiety degree and depression degree, were all increased in bladder cancer patients compared with HCs (all P < 0.001). Besides, the HADS-A score gradually increased from baseline to 3 years (P = 0.004), while the anxiety rate, HADS-D score, and depression rate did not change significantly (all P > 0.050). Gender, tumor size, marriage status, hypertension, diversity, and lymph node (LN) metastasis were associated with anxiety or depression in patients with bladder cancer (all P < 0.050). Anxiety was associated with shortened overall survival (OS) (P = 0.024) but did not link with disease-free survival (DFS) (P = 0.201); depression was not correlated with either DFS or OS (both P > 0.050). CONCLUSION: The prevalence and severity of anxiety and depression are high in patients with bladder cancer, which are influenced by gender, tumor features, marriage status, and hypertension; in addition, their correlation with survival is relatively weak.