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Prevalence, predictive factors, and screening for psychologic distress in patients with newly diagnosed head and neck cancer

  1. Akira Kugaya M.D., Ph.D.1,2,
  2. Tatsuo Akechi M.D., Ph.D.3,
  3. Toru Okuyama M.D., Ph.D.1,
  4. Tomohito Nakano M.D.1,
  5. Ichiro Mikami M.D.1,
  6. Hitoshi Okamura M.D., Ph.D.1,2,
  7. Yosuke Uchitomi M.D., Ph.D.1,2,*

Article first published online: 20 NOV 2000

DOI: 10.1002/1097-0142(20000615)88:12<2817::AID-CNCR22>3.0.CO;2-N

Issue

Cancer

Cancer

Volume 88, Issue 12, pages 2817–2823, 15 June 2000

Additional Information

How to Cite

Kugaya, A., Akechi, T., Okuyama, T., Nakano, T., Mikami, I., Okamura, H. and Uchitomi, Y. (2000), Prevalence, predictive factors, and screening for psychologic distress in patients with newly diagnosed head and neck cancer. Cancer, 88: 2817–2823. doi: 10.1002/1097-0142(20000615)88:12<2817::AID-CNCR22>3.0.CO;2-N

Author Information

  1. 1

    Psycho-Oncology Division, National Cancer Center Research Institute East, Kashiwa, Chiba, Japan

  2. 2

    Psychiatry Division, National Cancer Center Hospital East, Kashiwa, Chiba, Japan

  3. 3

    Psychiatry Division, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan

*Psycho-Oncology Division, National Cancer Center Research Institute East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, Japan 277-8577

Publication History

  1. Issue published online: 20 NOV 2000
  2. Article first published online: 20 NOV 2000
  3. Manuscript Accepted: 16 FEB 2000
  4. Manuscript Received: 26 MAY 1999
  5. Manuscript Revised: 16 FEB 1999

Funded by

  • Japanese Ministry of Health and Welfare. Grant Number: 9-31

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Keywords:

  • head and neck cancer;
  • psychologic distress;
  • prevalence;
  • predictive factors;
  • screening

Abstract

BACKGROUND

High levels of distress are a concern regarding patients with head and neck cancer. Early detection of and intervention for such distress are needed to predict patients' adaptation to treatment or rehabilitation, but few studies have investigated the detection of their distress in a patient population of significant size.

METHODS

The authors examined 107 consecutive patients with head and neck cancer to assess their psychologic distress (adjustment disorders or major depression) or other psychiatric problems by structured psychiatric interview before the initial cancer treatment. They also evaluated predictive factors for psychologic distress and assessed the ability of a self-rating questionnaire (Hospital Anxiety and Depression Scale, HADS) to screen for distress.

RESULTS

Of 107 subjects, 18 (16.8%) had an adjustment disorder or major depression. Thirty-six (33.6%), 7 (6.5%), and 35 (32.7%) met criteria for alcohol dependence, alcohol abuse, and nicotine dependence, respectively. Logistic regression analysis revealed that having advanced stage cancer (odds ratio, 5.77; 95% confidence interval [CI], 1.41–39.7; P = 0.03) and living alone (odds ratio, 4.83; 95% CI, 1.04–22.2; P = 0.04) were significantly associated with having psychologic distress. The optimal cutoff point for the HADS screening for psychologic distress was 15. This cutoff point gave 72.2% sensitivity and 81.4% specificity.

CONCLUSIONS

Head and neck cancer patients who have advanced disease or live alone should be assessed so that psychologic distress can be detected and intervention made. HADS is a useful clinical instrument to screen for their distress. Cancer 2000;88:2817–23. © 2000 American Cancer Society.

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