Correlation of resilience with anxiety and depression in patients with prostate cancer and analysis of influencing factors

Abstract

BACKGROUND

The development of prostate cancer (PC) frequently intensifies negative emotional states, such as anxiety and depression, which compromise the effectiveness of radical surgery and reduce treatment adherence. In this study, we hypothesized that psychological resilience plays a crucial role in this process and explored its impact.

AIM

To investigate the association of resilience with anxiety and depression in patients with PC and to analyze the influencing factors.

METHODS

We selected 147 patients with PC who visited Qingdao Traditional Chinese Medicine Hospital from January 2022 to June 2024. The resilience scores of patients with PC were assessed using the Connor-Davidson Resilience Scale (CD-RISC) from the tenacity, self-improvement, and optimism dimensions. Based on the total CD-RISC score, patients were categorized into groups A (total CD-RISC score > 63 points, n = 69) and B (total CD-RISC score ≤ 63 points, n = 78) for comparative analysis of anxiety [Hamilton Anxiety Rating Scale (HAMA)], depression [Hamilton Depression Rating Scale (HAMD)], sexual function [International Index of Erectile Function-5 (IIEF-5) and Sexual Life Quality Questionnaire-Quality of Life (SLQQ-QOL)], and quality of life [the EORTC Core Quality of Life Questionnaire (QLQ-C30)]. The association between CD-RISC and the above indicators was analyzed with Spearman correlation coefficients, and the influencing factors of resilience in patients with PC were identified with binary logistic regression.

RESULTS

Group A demonstrated statistically lower HAMA and HAMD scores and markedly higher scores of IIEF-5, SLQQ-QOL, and various QLQ-C30 aspects. Correlation analysis revealed that CD-RISC was significantly negatively correlated with HAMA and HAMD scores and significantly positively correlated with IIEF-5, SLQQ-QOL, and QLQ-C30 total scores. Binary logistic regression analysis revealed educational and per capita monthly household income levels as significant influencing factors of resilience in patients with PC.

CONCLUSION

Our results indicate a significant correlation of resilience with anxiety and depression in patients with PC. The milder the anxiety and depression emotions in patients, the higher their resilience. Further, assisting patients with PC to improve their educational and per capita monthly household income levels will help their resilience to some extent.

Keywords: Prostate cancer; Resilience; Anxiety; Depression; Analysis of influencing factors

Core Tip: Psychological resilience is an individual’s capacity to adapt to stressors and counteract the detrimental effects of future adverse events. In patients with prostate cancer, resilience acts as a protective buffer, facilitating effective emotional regulation and alleviating emotional distress. Despite its importance, research that examined the association between psychological resilience and anxiety or depression in patients with prostate cancer as well as the factors influencing this association remains limited. Our study reveals that higher psychological resilience levels are strongly associated with reduced anxiety and depression, improved sexual function, and enhanced overall quality of life. Furthermore, factors, such as higher educational attainment and greater monthly household income per capita positively contribute to the development of psychological resilience in these patients.