title: Psychosocial adjustment in head and neck cancer: the impact of disfigurement, gender and social support.
abstract: BACKGROUND
  The purpose of this study was to examine the psychosocial impact of disfigurement, gender, and social support after surgical treatment of head and neck cancer.
  
  
  METHODS
  Eighty-two ambulatory head and neck cancer patients, 6 months or more after treatment and free of active disease were assessed. Ratings of disfigurement were obtained using a valid and reliable 9-point scale developed for the study. Standardized measures of social support, depressive symptoms, well-being, and life happiness were used.
  
  
  RESULTS
  The sample as a whole displayed high levels of life happiness, low levels of depression, and positive feelings of well-being. Women demonstrated higher levels of depression and lower life happiness; subjects with greater disfigurement were more depressed. Social support seemed to buffer the impact of greater levels of disfigurement on well-being for women but not for men.
  
  
  CONCLUSIONS
  These results suggest that women with head and neck cancer who experience low social support and face disfiguring treatment are at greatest risk for psychosocial dysfunction.
authors.affiliation: Department of Psychiatry and Psychosocial Oncology Program, University Health Network-Toronto General Hospital/Princess Margaret Hospital, 610 University Avenue, Toronto, Ontario, Canada, M5G 2M9. mark.katz@uhn.on.ca
authors.forename: Mark R
authors.initials: MR
authors.lastname: Katz
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Irish
authors.forename: Gerald M
authors.initials: GM
authors.lastname: Devins
authors.forename: Gary M
authors.initials: GM
authors.lastname: Rodin
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Gullane
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001828:Body Image; D003430:Cross-Sectional Studies; D003627:Data Interpretation, Statistical; D003863:Depression / Q000523:psychology; D005260:Female; D006258:Head and Neck Neoplasms / Q000523:psychology* / Q000601:surgery*; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012044:Regression Analysis; D015203:Reproducibility of Results; D012494:Sampling Studies; D012737:Sex Factors; D012944:Social Support