Psychological distress among bladder cancer patients: A systematic review

Abstract

Purpose: Psychological distress, including depression and anxiety, is a significant yet often overlooked issue among bladder cancer patients. Despite its negative impact on treatment adherence, hospital stays, and overall survival, psychiatric distress remains underrepresented in clinical guidelines. This systematic review aims to assess the prevalence of psychiatric distress and its impact on bladder cancer patients while evaluating the role of psychiatric interventions in improving patient outcomes.

Methods: A systematic search was conducted across PubMed, Embase, ProQuest, Scopus, and Wiley Online Library following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Studies assessing psychiatric distress in bladder cancer patients and reporting the effects of psychiatric interventions were included. Data were extracted and analyzed qualitatively.

Results: Sixteen studies encompassing 96,175 participants were included. Anxiety prevalence ranged from 7% to 38.3%, while depression ranged from 6.9% to 42.8%, with both increasing posttreatment. These studies collectively revealed heightened rates of depression and anxiety among bladder cancer patients, along with compromised sleep quality and increased incidence of psychiatric disorders posttreatment. Despite the challenges posed by psychological distress, our review identified several studies highlighting the efficacy of psychiatric interventions, including counseling and support services, in ameliorating mental health challenges among bladder cancer patients. However, our study encountered limitations such as language restrictions and heterogeneity among included studies, precluding meta-analysis.

Conclusions: Bladder cancer imposes a significant psychological burden, yet mental health support remains underprioritized in clinical practice. Routine psychiatric screening and targeted interventions should be integrated into bladder cancer management to enhance patient well-being, treatment adherence, and overall outcomes.

Indraswari MT, Rahman F, Hamid ARAH, Mochtar CA. Psychological distress among bladder cancer patients: A systematic review. Urol Ann. 2026 Jan-Mar;18(1):10-17. doi: 10.4103/ua.ua_9_25. Epub 2026 Jan 20. PMID: 41696616; PMCID: PMC12904514.