title: Course of psychiatric comorbidity and utilization of mental health care after laryngeal cancer: a prospective cohort study.
abstract: In a German multi-center prospective cohort study, we wanted to assess the course of psychiatric comorbidity, utilization of mental health care and psychosocial care needs in laryngeal cancer patients during the first year after partial laryngectomy (PRL). Structured interviews with patients were conducted before surgery, 1 week (1 w), 3 months (3 m) and 1 year (12 m) after PRL. Psychiatric comorbidity was assessed using the Structured Clinical Interview for DSM-IV (SCID). Psychosocial care needs and utilization of mental health care were evaluated with standardized face-to-face interviews. In 176 patients, psychiatric disorders were prevalent in 11 % (1 w), 15 % (3 m) and 14 % (12 m), respectively, of which 4 % (12 m) underwent psychiatric treatment or psychotherapy. Two percent had acute, 15 % emerging and 6 % chronic psychiatric comorbidity. Chronically mental ill patients were more frequently younger than 65 years (p = 0.026), female (p = 0.045) and experienced more often a need for psychological counseling (p ≤ 0.001). One year after surgery, 27 % of the comorbid psychiatric patients expressed a need for additional psychological counseling. Alcohol-related disorders were diagnosed in 3 % (1 w), 3 % (3 m) and 8 % (12 m), respectively. Only one of these patients received psychological treatment, while 14 % expressed a need for psychological counseling and 7 % for additional medical consultations. The non-treatment of alcohol-related disorders measured in our sample indicates a major problem since continued alcohol consumption in laryngeal cancer patients is associated with reduced global quality of life, increased functional impairments and reduced overall survival. Screening instruments integrated into acute care are necessary to detect harmful drinking behavior.
authors.affiliation: Division Psychosocial Oncology, Department of Medical Psychology and Medical Sociology, University Medical Center, Leipzig, Germany. Judith.Keszte@medizin.uni-leipzig.de.
authors.forename: J
authors.identifier: http://orcid.org/0000-0002-2216-1548
authors.initials: J
authors.lastname: Keszte
authors.affiliation: Division Psychosocial Oncology, Department of Medical Psychology and Medical Sociology, University Medical Center, Leipzig, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Danker
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center, Leipzig, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Dietz
authors.affiliation: Department of Otorhinolaryngology, Clinical Center Sankt Georg, Leipzig, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Meister
authors.affiliation: Department of Otorhinolaryngology, Clinical Center Dresden-Friedrichstadt, Dresden, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Pabst
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital, Jena, Germany.
authors.forename: O
authors.initials: O
authors.lastname: Guntinas-Lichius
authors.affiliation: Department of Otorhinolaryngology, Clinical Center Chemnitz, Chemnitz, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Oeken
authors.affiliation: Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Mainz, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Singer
authors.affiliation: Division Psychosocial Oncology, Department of Medical Psychology and Medical Sociology, University Medical Center, Leipzig, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Meyer
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000150:complications* / Q000523:psychology* / Q000601:surgery; D007825:Laryngectomy; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D008605:Mental Health Services; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D011613:Psychotherapy; D011788:Quality of Life
keywords: Head and neck cancer; Mental disorders; Mental health care; Oncology; Psychosocial care needs; Transoral surgery