The course of symptoms of anxiety and depression from time of diagnosis up to 2 years follow-up in head and neck cancer patients treated with primary (chemo)radiation

F E van Beek; F Jansen; L Mak; B I Lissenberg-Witte; J Buter; M R Vergeer; J Voortman; P Cuijpers; C R Leemans; I M Verdonck-de Leeuw

doi:10.1016/j.oraloncology.2020.104576

The course of symptoms of anxiety and depression from time of diagnosis up to 2 years follow-up in head and neck cancer patients treated with primary (chemo)radiation

Oral Oncol. 2020 Mar:102:104576. doi: 10.1016/j.oraloncology.2020.104576. Epub 2020 Feb 3.

Authors

F E van Beek¹, F Jansen², L Mak¹, B I Lissenberg-Witte³, J Buter⁴, M R Vergeer⁵, J Voortman⁴, P Cuijpers¹, C R Leemans⁶, I M Verdonck-de Leeuw⁷

Affiliations

¹ Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, van der Boechorststraat 1, 1081 BT Amsterdam, the Netherlands.
² Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, van der Boechorststraat 1, 1081 BT Amsterdam, the Netherlands; Department of Otolaryngology-Head and Neck Surgery, Amsterdam Public Health Research Institute, AmsterdamUMC location VUmc, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands.
³ Department of Epidemiology and Biostatistics, Amsterdam UMC, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands.
⁴ Department of Medical Oncology, AmsterdamUMC location VUmc, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands.
⁵ Department of Radiation Oncology, AmsterdamUMC location VUmc, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands.
⁶ Department of Otolaryngology-Head and Neck Surgery, Amsterdam Public Health Research Institute, AmsterdamUMC location VUmc, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands.
⁷ Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, van der Boechorststraat 1, 1081 BT Amsterdam, the Netherlands; Department of Otolaryngology-Head and Neck Surgery, Amsterdam Public Health Research Institute, AmsterdamUMC location VUmc, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands. Electronic address: im.verdonck@amsterdamumc.nl.

PMID: 32028135
DOI: 10.1016/j.oraloncology.2020.104576

Abstract

Objectives: To identify sociodemographic and clinical factors, health-related quality of life (HRQOL) and head and neck cancer (HNC) symptoms associated with the course of symptoms of anxiety and depression from pretreatment to 24-month follow-up among HNC patients after (chemo)radiation.

Materials and methods: Patients (n = 345) completed questionnaires on anxiety and depression (HADS), HRQOL and symptoms (EORTC QLQ-C30/QLQ-H&N35) before treatment, and 6-weeks,3-,6-12-,18-, and 24-months after treatment. Mixed model analyses were used to investigate the course of anxiety and depression from pretreatment to 24-months in relation to factors assessed at baseline, and the course of anxiety and depression from 6- to 24-months, in relation to factors assessed at 6-months.

Results: Increased risk for anxiety (HADS-anxiety > 7) was 28.7% among patients before treatment, which declined to 10.0% at 24-months. Increased risk for depression (HADS-depression > 7) was 15.1% before treatment, 18.2% at 3-months, 7.2% at 12-months and 16.0% at 24-months. Factors assessed at baseline which were significantly associated with the course of anxiety were age, pain, problems with social contact, and feeling ill, whereas chemotherapy, worse emotional functioning, speech problems and weight loss were significantly associated with the course of depression. Regarding factors assessed at 6-months, chemotherapy, worse cognitive and social functioning, insomnia, swallowing problems and trouble with social eating were associated with the course of anxiety. Nausea/vomiting, dyspnea, coughing, and feeling ill were associated with the course of depression (p-values < 0.05).

Discussion: Factors associated with a worse course of anxiety and depression are younger age, treatment with chemotherapy, worse HRQOL and higher symptom burden.

Keywords: Anxiety; Depression; Head and Neck cancer; Longitudinal; Oral cancer; Psychology.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Aged, 80 and over
Anxiety / diagnosis*
Anxiety / etiology
Depression / diagnosis*
Depression / etiology
Female
Follow-Up Studies
Head and Neck Neoplasms / diagnosis
Head and Neck Neoplasms / drug therapy
Head and Neck Neoplasms / psychology*
Head and Neck Neoplasms / radiotherapy
Humans
Male
Middle Aged
Patient Reported Outcome Measures
Prospective Studies
Quality of Life
Symptom Assessment
Time Factors