title: Anxiety and depression in patients after surgery for head and neck cancer in Japan.
abstract: The present study sought to examine the impact of physical symptoms, facial disfigurement, adequacy of preoperative information, and social support on anxiety and depression in Japanese patients with head and neck cancer (HNC) who had undergone surgery.
  
  
  
  A cross-sectional study with 194 patients was conducted using a self-administered questionnaire. This instruments included the Hospital Anxiety and Depression Scale (HADS), the European Organization for Research and Treatment of Cancer (EORTC) Head and Neck cancer module (QLQ-H&N35), and a Social Support Scale developed by Okabayashi et al. (1997).
  
  
  
  The majority (56.7%) had surgery two or more years before completing the questionnaire. More than 25% of respondents showed anxiety or depression. Higher levels of perceived social support were associated with lower rates of anxiety and depression (p < 0.01). Sensory problems were associated with anxiety, and reduced sexuality was associated with depression (p < 0.01). Perceived disfigurement and adequacy of preoperative information were not associated with anxiety or depression.
  
  
  
  Survivors of HNC experience anxiety and depression for an extended period of time. Social support may alleviate the severity of these disorders. More research is needed to confirm the impact of facial disfigurement and that of the preoperative information provided by surgeons on psychological distress in HNC patients.
authors.affiliation: Department of Nursing,Cancer Institute Hospital of Japanese Foundation for Cancer Research,Tokyo,Japan.
authors.forename: Miho
authors.initials: M
authors.lastname: Suzuki
authors.affiliation: Graduate School of Education,University of Tokyo,Tokyo,Japan.
authors.forename: Minako
authors.initials: M
authors.lastname: Deno
authors.affiliation: Division of Community-Based Comprehensive Dentistry,Department of Special Needs Dentistry,School of Dentistry,Showa University,Tokyo,Japan.
authors.forename: Mie
authors.initials: M
authors.lastname: Myers
authors.affiliation: Department of Head and Neck Surgery,Tokyo Medical and Dental University,Tokyo,Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Asakage
authors.affiliation: Division of Oral Rehabilitation Medicine,Department of Special Needs Dentistry,School of Dentistry,Showa University,Tokyo,Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Department of Dentistry and Oral Surgery,Kanto Medical Center NTT EC,Tokyo,Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Saito
authors.affiliation: Department of Dentistry,Oral and Maxillofacial Surgery,Jichi Medical University,Tochigi,Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Mori
authors.affiliation: Department of Dentistry and Oral Surgery,Tokyo Metropolitan Health and Medical Treatment Corporation,Ebara Hospital,Tokyo,Japan.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Saito
authors.affiliation: Department of Oral Surgery,Tokyo Metropolitan Health and Medical Treatment Corporation,Toshima Hospital,Tokyo,Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ichikawa
authors.affiliation: Department of Adult Health Nursing/Palliative Care Nursing,Graduate School of Medicine,University of Tokyo,Tokyo,Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Yamamoto-Mitani
authors.affiliation: Department of Palliative Nursing,Health Sciences,Tohoku University Graduate School of Medicine,Miyagi,Japan.
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Miyashita
mesh_terms: D000368:Aged; D001007:Anxiety / Q000209:etiology / Q000523:psychology; D000013:Congenital Abnormalities / Q000209:etiology / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology / Q000523:psychology; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications / Q000523:psychology / Q000601:surgery*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011594:Psychometrics / Q000295:instrumentation / Q000379:methods; D011788:Quality of Life / Q000523:psychology*; D012944:Social Support; D013514:Surgical Procedures, Operative / Q000009:adverse effects* / Q000523:psychology; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*
keywords: Anxiety; Depression; Head and neck cancer; Social support; Survivors