Risks of depression, anxiety, and suicide in partners of men with prostate cancer: a national cohort study

Background: A diagnosis of prostate cancer (PC) may cause psychosocial distress not only in a man but also in his intimate partner. However, long-term risks of depression, anxiety, or suicide in partners of men with PC are largely unknown. Methods: A national cohort study was conducted of 121 530 partners of men diagnosed with PC during 1998-2017 and 1 093 304 population-based controls in Sweden. Major depression, anxiety disorder, and suicide death were ascertained through 2018. Cox regression was used to compute hazard ratios (HRs) while adjusting for sociodemographic factors. Results: Partners of men with high-risk PC had increased risks of major depression (adjusted HR ¼ 1.34, 95% confidence interval [CI] ¼ 1.30 to 1.39) and anxiety disorder (adjusted HR ¼ 1.25, 95% CI ¼ 1.20 to 1.30), which remained elevated 10 or more years later. Suicide death was increased in partners of men with distant metastases (adjusted HR ¼ 2.38, 95% CI ¼ 1.08 to 5.22) but not other high-risk PC (adjusted HR ¼1.14, 95% CI ¼ 0.70 to 1.88). Among partners of men with high-risk PC, risks of major depression and anxiety disorder were highest among those 80 years of age or older (adjusted HR ¼ 1.73; 95% CI ¼ 1.53 to 1.96; adjusted HR ¼ 1.70, 95% CI ¼ 1.47 to 1.96, respectively), whereas suicide death was highest among those younger than 60 years of age (adjusted HR ¼ 7.55, 95% CI ¼ 2.20 to 25.89). In contrast, partners of men with low- or intermediate-risk PC had modestly or no increased risks of these outcomes. Conclusions: In this large cohort, partners of men with high-risk PC had increased risks of major depression and anxiety disorder, which persisted for 10 or more years. Suicide death was increased 2-fold in partners of men with distant metastases. Partners as well as men with PC need psychosocial support and close follow-up for psychosocial distress.