A prospective multicentre study in Sweden and Norway of mental distress and psychiatric morbidity in head and neck cancer patients

Abstract

Summary A Swedish/Norwegian head and neck cancer study was designed to assess prospectively the levels of mental distress and psychiatric morbidity in a heterogeneous sample of newly diagnosed head and neck cancer patients. A total of 357 patients were included. The mean age was 63 years, and 72% were males. The patients were asked to answer the HAD scale (the Hospital Anxiety and Depression scale) six times during 1 year. The number of possible or probable cases of anxiety or depression disorder was calculated according to standardized cut-offs. Approximately one-third of the patients scored as a possible or probable case of a major mood disorder at each measurement point during the study year. There were new cases of anxiety or depression at each time point. The anxiety level was highest at diagnosis, while depression was most common during treatment. Females were more anxious than males at diagnosis, and patients under 65 years of age scored higher than those over 65. Patients with lower performance status and more advanced disease reported higher levels of mental distress and more often scored as a probable or possible cases of psychiatric disorder. Our psychometric analyses supported the two-dimensional structure and stability of the HAD scale. The HAD scale seems to be the method of choice for getting valid information about the probability of mood disorder in head and neck cancer populations. The prevalence of psychiatric morbidity found in this study emphasizes the importance of improved diagnosis and treatment.

Coping and psychological distress among head and neck cancer patients

“…Hammerlid et al studied 357 head and neck cancer patients prospectively and found that women had significantly higher levels of anxiety at diagnosis as well as at one year follow-up than men. Similar finding was reported in regard to age, where younger patients were significantly more anxious than older patients (67). In another prospective study to assess fear of recurrence among orofacial cancer patients; females had also high levels of anxiety compared to males at 3 months following treatment (89).…”

“…This cut-off is validated and commonly used in the literature to detect all possible cases of anxiety and depression (66)(67)(68) The HAD scale was designed and widely used as a screening instrument because it is a brief self assessment tool. In 2002, Bjelland et al reviewed 747 papers that used the HAD scale and confirmed its ability as a screening tool for detecting anxiety and depression (69).…”

Treatment Delay in Oral and Oropharyngeal Cancer in Our Population: The Role of Socio-Economic Factors and Health-Seeking Behaviour

“…The use of alternative medicine and the treatment delay caused by that has been well-documented in the past [9,22,23]. In the developed countries, the use of alternative medicine is primarily attributable to the psychological distress over potential, often mutilating treatments [24,25]. However, in our study the consultation of unqualified local practitioners/alternative medicine could be attributed to the sheer ignorance and lack of primary health care facilities as most of such consultations were sought by the individuals with low literacy levels/who had no access to a PHC/who were unaware of their probable diagnosis.…”

The association between previous psychological trauma and mental health among gastric cancer patients

“…A longitudinal study 8 found that across six points of measurement during one year, the rate of anxiety among esophagus or gastroesophageal junction cancer patients was 16% to 34% while for depression the scores were a little bit higher and ranged from 27% to 44%. The main conclusion of the study was that psychiatric morbidity is common among esophageal cancer patients, both at inclusion and over time 8,9 . Summarizing reviews of depression in cancer raise a challenge as depressive symptoms occur on a broad spectrum that ranges from sadness to major affective disorder and because affect changes drastically making it difficult to assess when a patient is in a constant threat for life 10 .…”