Health-related quality of life in head and neck cancer survivors: impact of pretreatment depressive symptoms.
OBJECTIVE
Symptoms of depression are common in those with cancer. The authors investigated whether depressive symptoms assessed before the initiation of cancer treatment predicted diminished health-related quality of life (HRQOL) at follow-up.


METHODS
As part of a large, prospective study of oncologic outcomes, 306 patients with head and neck cancer (HNC) were assessed on several clinical and psychosocial characteristics during a pretreatment clinic visit and then at 3- and 12-month follow-up appointments.


METHODS
Depressive symptomatology was assessed with the Beck Depression Inventory and HNC-specific HRQOL (main outcome measure) was assessed with the Head and Neck Cancer Inventory.


RESULTS
Controlling for age, gender, marital status, cancer site, stage of disease, alcohol and tobacco use, comorbidity status, and pretreatment HRQOL, simultaneous multiple regression analyses revealed that depressive symptoms present at study enrollment, before the initiation of cancer treatment, significantly predicted lower HRQOL at 3- and 12-month follow-up assessments across the 4 HNC-specific domains of speech, eating, aesthetics, and social disruption (all ps <or= .01).


CONCLUSIONS
Results suggest that depressive symptomatology present near the time of diagnosis can have a significant, deleterious impact on HRQOL over time in HNC survivors. Thus, it may be useful to assess depression at diagnosis to identify individuals at greater risk for poor HRQOL outcomes.
Howren
M Bryant
MB
Department of Psychology, Center for Research in the Implementation of Innovative Strategies in Practice, Iowa City Veterans Affairs (VA) Medical Center, Iowa City, IA 52242, USA. matthew-howren@uiowa.edu
Christensen
Alan J
AJ
Karnell
Lucy Hynds
LH
Funk
Gerry F
GF
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006258:Head and Neck Neoplasms / Q000145:classification / Q000401:mortality* / Q000523:psychology*; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011584:Psychology; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D015996:Survival Rate; D055815:Young Adult