The association of the use of anxiety and depression medications with PSA testing

ABSTRACT

Background: Mental illness is a growing issue in the USA. More individuals continue to be diagnosed with illnesses such as depression and anxiety and placed on necessary medications. Studies have shown that the psychological makeup of an individual greatly impacts their health behavior and usage of preventative measures. However, there is limited research on the effect of anxiety and depression on PSA testing. This study explores the associations between the use of anxiety and depression medications and PSA testing. Methods: We used data from the National Health Interview Survey during the year 2018, and assessed responses to the question "Have you ever had a PSA test?" and "What is the number of PSA tests you had in the last 5 years?". Responses were stratified by whether men were taking medications for anxiety, depression, both or none. We performed multivariable logistic regression analysis to define adjusted odds ratios of undergoing PSA testing adjusting for relevant socio-economic and demographic parameters. Results: Among the 5,035 male participants, 89.4% did not take any medication, 2.9% reported they took anxiety medication, 2.1% took depression medication and 5.5% took both medications. There was a significantly higher rate of PSA testing in men who took medications for both anxiety and depression compared to men taking no medications (p=0.002). Furthermore, the average number of PSA tests in the last 5 years was highest in the group of men taking both medications (p < 0.0001). Multivariable analysis showed that men who took medications for both depression and anxiety were more likely to undergo PSA testing in comparison to men, not on any of these medications (OR=1.755, p=0.001). The multivariable analysis also showed that age, living with a spouse, and prior cancer history were associated with an increased likelihood of PSA testing while being a minority, living in the south of the USA, and being a current smoker was associated with a lower likelihood of undergoing PSA testing. Conclusions: Taking both anxiety and depression medications in men may be associated with a higher likelihood of undergoing PSA testing. Despite obvious limitations of this analysis including its retrospective nature and recall bias, this association needs to be further explored, especially due to rising use of these medication in the current era of the COVID-19 pandemic.