Association between depression and survival or disease recurrence in patients with head and neck cancer enrolled in a depression prevention trial.
BACKGROUND
To determine if depression portends a worse prognosis in patients with head and neck cancer, we conducted a retrospective chart analysis of subjects who participated in a randomized placebo-controlled trial of citalopram for the prevention of depression during head and neck cancer treatment. Thirty-five patients were randomized, 34 with 1 or more evaluations form the basis of this report.


METHODS
We used the Hamilton Depression Rating Scale (HDRS), with a minimum follow-up of 24 months if no evidence of disease, or until recurrence or death from disease.


RESULTS
Fourteen of 34 subjects were depressed at any time during the 16 week RCT (HAMD >15). Seven of the 14 subjects in the depressed group were dead from disease or had recurrence, compared to 4 of 20 who never developed depression (p = .03). Stage of disease was equivalent in the 2 groups.


CONCLUSIONS
This study suggests that depression in patients with head and neck cancer reduces survival.
Lazure
Kathryn E
KE
Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Lydiatt
William M
WM
Denman
David
D
Burke
William J
WJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000523:psychology* / Q000628:therapy; D015283:Citalopram / Q000627:therapeutic use; D015331:Cohort Studies; D003866:Depressive Disorder / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000523:psychology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000523:psychology* / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram