title: Posttraumatic growth, depression and anxiety in head and neck cancer patients: examining their patterns and correlations in a prospective study.
abstract: BACKGROUND
  Positive and negative psychological reactions have been described in head and neck cancer patients. Nevertheless, the relationships between these responses across time need to be studied to understand the patients' strengths and vulnerabilities.
  
  
  OBJECTIVE
  The aim of this study is to determine the changes in posttraumatic growth (PTG), depression and anxiety longitudinally and the correlations between PTG and depression and anxiety in head and neck cancer patients.
  
  
  METHODS
  A prospective study was conducted on 60 head and neck cancer patients within a year of diagnosis recruited from an oncology referral centre in Malaysia with 50 patients completing the study. The PTG Inventory-Short Form (PTGI-SF) and Hospital Anxiety and Depression Scale (HADS) were used at baseline and at 6 months follow-up.
  
  
  RESULTS
  There were significant reductions in the scores of PTGI-SF (mean difference = -5.5, p = 0.014), HADS (Depression) (mean difference = -2.0, p < 0.05) and HADS (Anxiety) (mean difference = -2.0, p < 0.05) from baseline to follow-up. However, their correlations were not significant. HADS (Depression) score at baseline showed weak inverse correlation with PTGI-SF score (rho = -0.147, p = 0.309), whereas PTGI-SF score had weak positive correlations with HADS (Anxiety) at baseline (rho = 0.261, p = 0.067), HADS (Depression) at follow-up (rho = 0.083, p = 0.566) and HADS (Anxiety) at follow-up (rho = 0.111, p = 0.445). HADS scores also did not predict total PTGI-SF score longitudinally.
  
  
  CONCLUSIONS
  There were reductions in PTG, depression and anxiety within a year of cancer diagnosis and 6 months later with no significant correlations between PTG with depression and anxiety.
authors.affiliation: Advanced Medical and Dental Institute, Universiti Sains Malaysia, Penang, Malaysia.
authors.forename: Mohammad Farris Iman
authors.initials: MF
authors.lastname: Leong Abdullah
authors.affiliation: Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: Nik Ruzyanei
authors.initials: NR
authors.lastname: Nik Jaafar
authors.affiliation: Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: Hazli
authors.initials: H
authors.lastname: Zakaria
authors.affiliation: Department of Oral and Maxillofacial Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: Rama Krsna
authors.initials: RK
authors.lastname: Rajandram
authors.affiliation: Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: Raynuha
authors.initials: R
authors.lastname: Mahadevan
authors.affiliation: Department of Otorhinolaryngology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: Mohd Razif
authors.initials: MR
authors.lastname: Mohamad Yunus
authors.affiliation: Department of Epidemiology and Public Health, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: Shamsul Azhar
authors.initials: SA
authors.lastname: Shah
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology* / Q000523:psychology; D003863:Depression / Q000209:etiology* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013315:Stress, Psychological / Q000209:etiology*
keywords: anxiety; depression; head and neck cancer; oncology; posttraumatic growth