title: Health-related quality of life in head and neck cancer survivors: impact of pretreatment depressive symptoms.
abstract: 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.
authors.affiliation: 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
authors.forename: M Bryant
authors.initials: MB
authors.lastname: Howren
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Christensen
authors.forename: Lucy Hynds
authors.initials: LH
authors.lastname: Karnell
authors.forename: Gerry F
authors.initials: GF
authors.lastname: Funk
mesh_terms: 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