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Correlation Between Depression and High Decipher Scores in men Diagnosed with Prostate Cancer.



Interest has grown in understanding the connection between the state of mind of an individual and its effect on the body at the molecular level. Studies suggest that mental stress can alter the biochemical functions of the body (Juster, 2010). Depression is an example of a condition associated with mental stress. Exposure to environmental stresses is essential to the development of major depression, which in turn has been shown to affect the body systems in several ways. These effects are exerted at three main levels: genetic, molecular and neural. (Kupfer, 2016). Evidence is beginning to emerge that depression can lead to epigenetic changes in the human genome. Studies have also shown that epigenetic changes are critical to the development of many human malignancies including prostate cancer. It is therefore possible that these two processes may be linked, and that the presence of depression could predispose the individual to the development of cancers. Epigenetic mechanisms include DNA methylation, histone acetylation or methylation and post-translational effects of non-coding RNAs.

The Decipher genomic classifier (GC) uses coding and noncoding RNA to predict men with prostate cancer who are at risk for aggressive disease or disease progression. Using the Decipher genomic classifier as a surrogate for coding and noncoding RNA, we seek to demonstrate a possible association between depression and a tendency for developing aggressive prostate cancer. A multivariable logistic regression comparing Decipher scores in depressed subjects will first be done using depression as a continuous variable adjusting for age, SES and total illness burden index and again after dichotomizing subjects into depressed vs. non-depressed with the same adjustments. We will also seek to demonstrate that high levels of resilience attenuate this association.

A limitation of this study is that a correlation is not proof of direct causation. However, a positive association between depression and the 22 RNA components of the Decipher GC may suggest that at least one of these RNAs may be of interest in the epigenetic mechanisms connecting depression and prostate cancer which could be basis for further studies in the future.

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