Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Sep;27(9):2245-2256.
doi: 10.1002/pon.4816. Epub 2018 Jul 23.

Depressive symptoms in relation to overall survival in people with head and neck cancer: A longitudinal cohort study

Femke Jansen  1 , Irma M Verdonck-de Leeuw  1   2 , Pim Cuijpers  2 , C René Leemans  1 , Tim Waterboer  3 , Michael Pawlita  3 , Chris Penfold  4   5 , Steven J Thomas  5 , Andrea Waylen  5 , Andrew R Ness  4   5
Affiliations

Depressive symptoms in relation to overall survival in people with head and neck cancer: A longitudinal cohort study

Femke Jansen et al. Psychooncology. 2018 Sep.

Abstract

Objective: The objective of the study is to investigate the relation between pretreatment depressive symptoms (DS) and the course of DS during the first year after cancer diagnosis, and overall survival among people with head and neck cancer (HNC).

Methods: Data from the Head and Neck 5000 prospective clinical cohort study were used. Depressive symptoms were measured using the Hospital Anxiety and Depression Scale (HADS) pretreatment, at 4 and 12-month follow-up. Also, socio-demographic, clinical, lifestyle, and mortality data were collected. The association between before start of treatment DS (HADS-depression > 7) and course (never DS, recovered from DS, or persistent/recurrent/late DS at 12-month follow-up) and survival was investigated using Cox regression. Unadjusted and adjusted analyses were performed.

Results: In total, 384 of the 2144 persons (18%) reported pretreatment DS. Regarding DS course, 63% never had DS, 16% recovered, and 20% had persistent/recurrent/late DS. People with pretreatment DS had a higher risk of earlier death than people without DS (hazard ratio (HR) = 1.65; 95% confidence interval (CI) 1.33-2.05), but this decreased after correcting for socio-demographic, clinical, and lifestyle-related factors (HR = 1.21; 95% CI 0.97-1.52). Regarding the course of DS, people with persistent/recurrent/late DS had a higher risk of earlier death (HR = 2.04; 95% CI 1.36-3.05), while people who recovered had a comparable risk (HR = 1.12; 95% CI 0.66-1.90) as the reference group who never experienced DS. After correcting for socio-demographic and clinical factors, people with persistent/recurrent/late DS still had a higher risk of earlier death (HR = 1.66; 95% CI 1.09-2.53).

Conclusions: Pretreatment DS and persistent/recurrent/late DS were associated with worse survival among people with HNC.

Keywords: cancer; depression; depressive symptoms; head and neck cancer; mortality; oncology; survival.

PubMed Disclaimer

References

    1. Satin JR, Linden W, Phillips MJ. Depression as a predictor of disease progression and mortality in cancer patients: A meta‐analysis. Cancer. 2009;115(22):5349‐5361. - PubMed
    1. Pinquart M, Duberstein PR. Depression and cancer mortality: A meta‐analysis. Psychol Med. 2010;40:1797‐1810. - PMC - PubMed
    1. Cuijpers P, Vogelzangs N, Twisk J, Kleiboer A, Li J, Penninx BW. Comprehensive meta‐analysis of excess mortality in depression in the general community versus patients with specific illnesses. Am J Psychiatry. 2014;171:453‐462. - PubMed
    1. Krebber AM, Buffart LM, Kleijn G, et al. Prevalence of depression in cancer patients: A meta‐analysis of diagnostic interviews and self‐report instruments. Psychooncology. 2014;23:121‐130. - PMC - PubMed
    1. Haisfield‐Wolfe ME, McGuire DB, Soeken K, Geiger‐Brown J, De Forge BR. Prevalence and correlates of depression among patients with head and neck cancer: A systematic review of implications for research. Oncol Nurs Forum. 2009;36:E107‐E125. - PubMed

Publication types