Thursday, February 28, 2019

Prevalence of Mental Disorders Higher in Patients With Head, Neck Cancers After Cancer Diagnosis

Patients with cancers of the head and neck are more likely to have an increased prevalence of mental health disorders after their cancer is diagnosed compared with the general population, according to a report published today in JAMA Otolaryngology-Head and Neck Surgery.

There appears to be an especially strong association between mental health disorders and cancers of the trachea. Additionally, patients who received multimodal therapy—radiotherapy, chemotherapy, and/or surgery—have a higher risk of developing mental health disorders compared with those who receive only surgery, according to the report.

“High mortality and morbidity associated with HNCs [head and neck cancers] may predispose these patients to MHDs [mental health disorders],” wrote Neerav Goyal, M.D., M.P.H., of Pennsylvania State University and colleagues. “In addition, morbidity is associated with the treatment.”

Goyal and colleagues analyzed data from the Truven Health Market Scan Commercial Claims and Encounters database from January 1, 2005, through December 31, 2014. They tracked diagnostic codes from ICD-9-CM associated with head and neck cancers and mental health disorders. Head and neck cancers included cancer of the lip, tongue, oral cavity, oropharynx, nasopharynx, hypopharynx, nasal cavity and sinus, larynx, trachea, mandible, Kaposi sarcoma of the palate, and malignant neoplasm of the head and neck. Mental health disorders included episodic mood disorders, including depression, anxiety, nonalcohol drug dependence, adjustment reaction, and depressive disorder not otherwise specified.

The researchers measured the prevalence of mental health disorders and compared points before and after the diagnosis of head and neck cancers. In this cohort study of 52,641 patients with a diagnosis of head and neck cancer, the proportion with mental health disorders at baseline was 20.6% compared with the national average of 17.9%, as estimated by the National Survey on Drug Use and Health. After diagnosis, the prevalence rose to 29.9%. Patients with tracheal cancers had twice the odds of developing mental health disorders compared with patients with oral cavity cancer.

A total of 15.2% of the cohort received radiotherapy, chemotherapy, and surgery; 12.9%, radiotherapy and surgery; and 2.9%, chemotherapy and surgery. Patients who received all three treatments were more likely to develop mental health disorders than those who had only surgery.

Patients with head and neck cancer should be monitored for mental health issues, Goyal and colleagues wrote. “Our results further support the importance of addressing psychosocial needs in routine treatment discussions.”

For related information, see the Psychiatric News article “Researchers Look at Improving Well-Being of Families Affected by Cancer.”



The content of Psychiatric News does not necessarily reflect the views of APA or the editors. Unless so stated, neither Psychiatric News nor APA guarantees, warrants, or endorses information or advertising in this newspaper. Clinical opinions are not peer reviewed and thus should be independently verified.