Affective symptoms and swallow‐specific quality of life in total laryngectomy patients

Abstract

Background: The aim of this study is to determine the prevalence of clinically relevant affective symptoms and level of swallow-specific quality of life (QoL) in dysphagic patients with total laryngectomy (TL) and to explore the relationship between affective symptoms and swallow-specific QoL. Methods: Thirty-five TL patients completed the Hospital Anxiety and Depression Scale (HADS) and the MD Anderson Dysphagia Inventory (MDADI). Student's t test and linear regression were used. Results: Eight (23%) patients showed clinically relevant symptoms of anxiety, 8 (23%) of depression, and 11 (31%) showed either one. These groups had significantly lower mean MDADI scores. One-point increase in HADS-anxiety or HADS-depression subscale score corresponds with a decrease of 2.7 or 3.0 points, on average, respectively, of the MDADI total score. Conclusions: Clinically relevant affective symptoms were present in approximately one-third of the TL patients. These preliminary results show that increased affective symptom scores correlate with a decreased swallow-specific QoL.

Associations between markers of social functioning and depression and quality of life in survivors of head and neck cancer: Findings from the Head and Neck Cancer 5000 study

“…14 Small studies found those with depressive symptoms reported poorer swallowing-specific QOL outcomes. 15,16 A systematic review found symptoms of depression were common in patients with dysphagia of mixed aetiologies, observing associations with both swallowing impairment measures as well as self-report questionnaires, although few studies recruited both dysphagic and non-dysphagic participants. 17 A small difference in Hospital Anxiety and Depression Scale (HADS) scores for both depression and anxiety was noted in HNC survivors who aspirated on drinks compared to those who did not, 18 suggesting that swallowing impairment negatively impacted on mood.…”

“…A relatively strong correlation between swallowing self‐report and QOL outcomes ( r = 0.69–0.83) was reported in the first year following radiotherapy, but the number recruited to the study was relatively small ( n = 167) 14 . Small studies found those with depressive symptoms reported poorer swallowing‐specific QOL outcomes 15,16 . A systematic review found symptoms of depression were common in patients with dysphagia of mixed aetiologies, observing associations with both swallowing impairment measures as well as self‐report questionnaires, although few studies recruited both dysphagic and non‐dysphagic participants 17 .…”

Common mental disorders and patient-reported swallowing disorders following total laryngectomy

“…Being able to swallow is the third major concern of patients diagnosed with laryngeal cancer in relation to treatment of the disease, only after the cure of cancer and the expectation of living as long as possible 9 . Swallowing disorders following total laryngectomy can lead the patient to eating alone or losing the pleasure to eat, which can lead to impairment in social function and a decrease in quality of life [10][11][12] .…”

“…Therefore, it is understood that dysphagia can restrict an individual's relationship with their daily life, which allows us to assume that psychiatric disorders such as Common Mental Disorders (CMD) might emerge. The intensity and chronicity of CMD are related to developing diseases such as anxiety and depression [10][11][12][13][14] , which is why CMD screening is important in patients with swallowing complaints, especially in cases associated with head and neck cancer in which there is a markedly greater risk of psychological distress and worse quality of life 15 .…”

“…Previous studies evaluated the relationships between surgeries for head and neck cancer and specific psychological impairment such as anxiety, depression and stress [10][11][12][13][14][15]19,20 . However, even though there are signs that complaints of dysphagia in total laryngectomized patients are associated with impairments in mental health 21 , the relationship between CMD and patient-reported swallowing outcomes in these patients is unknown.…”