Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-19T04:47:43.023Z Has data issue: false hasContentIssue false
  • English
  • Français

Value of the Hospital Anxiety and Depression Scale in the follow up of head and neck cancer patients

Published online by Cambridge University Press:  11 February 2013

L A Joseph ,
J A Routledge ,
M P Burns ,
R Swindell ,
A J Sykes ,
N J Slevin  and
S E Davidson
L A Joseph
Affiliation:
Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
J A Routledge
Affiliation:
Radiation Related Research, The Christie NHS Foundation Trust, Manchester, UK
M P Burns
Affiliation:
Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
R Swindell
Affiliation:
Department of Statistics, The Christie NHS Foundation Trust, Manchester, UK
A J Sykes
Affiliation:
Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
N J Slevin
Affiliation:
Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
S E Davidson*
Affiliation:
Radiation Related Research, The Christie NHS Foundation Trust, Manchester, UK
*
Address for correspondence: Dr Susan Davidson, Department of Clinical Oncology, Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK Fax: +44 (0)161 446 8111 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Few studies have prospectively investigated psychological morbidity in UK head and neck cancer patients. This study aimed to explore changes in psychological symptoms over time, and associations with patients' tumour and treatment characteristics, including toxicity.

Methods:

Two hundred and twenty patients were recruited to complete the Hospital Anxiety and Depression Scale and the Late Effects on Normal Tissue (Subjective, Objective, Management and Analytic) (‘LENT-SOMA’) questionnaires, both pre- and post-treatment.

Results:

Anxiety was highest pre-treatment (38 per cent) and depressive symptoms peaked at the end of treatment (44 per cent). Anxiety significantly decreased and depression significantly increased, comparing pre- versus post-treatment responses (p < 0.001). Hospital Anxiety and Depression Scale scores were significantly correlated with toxicity, age and chemotherapy (p < 0.01 for all).

Conclusion:

This is the first study to analyse the relationship between Hospital Anxiety and Depression Scale scores and toxicity scores in head and neck cancer patients. It lends support for the use of the Hospital Anxiety and Depression Scale and the Late Effects on Normal Tissue (Subjective, Objective, Management and Analytic) questionnaire in routine clinical practice; furthermore, continued surveillance is required at multiple measurement points.

Keywords

AnxietyDepressionOtolaryngologyCarcinoma
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 3 , March 2013 , pp. 285 - 294
Copyright
Copyright © JLO (1984) Limited 2013

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Parkin, DM, Bray, F, Ferlay, J, Pisani, P. Global cancer statistics, 2002. CA Cancer J Clin 2005;55:74–108CrossRefGoogle ScholarPubMed
2Katz, MR, Kopek, N, Waldron, J, Devins, GM, Tomlinson, G. Screening for depression in head and neck cancer. Psychooncology 2004;13:269–80CrossRefGoogle ScholarPubMed
3Kugaya, A, Akechi, T, Okuyama, T, Nakano, T, Mikami, I, Okamura, H et al. Prevalence, predictive factors, and screening for psychologic distress in patients with newly diagnosed head and neck cancer. Cancer 2000;88:2817–233.0.CO;2-N>CrossRefGoogle ScholarPubMed
4Singer, S, Krauss, O, Keszte, J, Siegl, G, Papsdorf, K, Severi, E et al. Predictors of emotional distress in patients with head and neck cancer. Head Neck 2012;34:180–7CrossRefGoogle ScholarPubMed
5de Leeuw, JR, de Graeff, A, Ros, WJ, Blijham, GH, Hordijk, GJ, Winnubst, JA. Prediction of depressive symptomatology after treatment of head and neck cancer: the influence of pre-treatment physical and depressive symptoms, coping, and social support. Head Neck 2000;22:799–8073.0.CO;2-E>CrossRefGoogle ScholarPubMed
6Duffy, SA, Ronis, DL, Valenstein, M, Fowler, KE, Lambert, MT, Bishop, C et al. Depressive symptoms, smoking, drinking, and quality of life among head and neck cancer patients. Psychosomatics 2007;48:142–8CrossRefGoogle ScholarPubMed
7Zabora, J, BrintzenhofeSzoc, K, Curbow, B, Hooker, C, Piantadosi, S. The prevalence of psychological distress by cancer site. Psychooncology 2001;10:19–283.0.CO;2-6>CrossRefGoogle ScholarPubMed
8Singer, S, Kuhnt, S, Gotze, H, Hauss, J, Hinz, A, Liebmann, A et al. Hospital anxiety and depression scale cutoff scores for cancer patients in acute care. Br J Cancer 2009;100:908–12CrossRefGoogle ScholarPubMed
9Carlson, LE, Angen, M, Cullum, J, Goodey, E, Koopmans, J, Lamont, L et al. High levels of untreated distress and fatigue in cancer patients. Br J Cancer 2004;90:2297–304CrossRefGoogle ScholarPubMed
10Sollner, W, DeVries, A, Steixner, E, Lukas, P, Sprinzl, G, Rumpold, G et al. How successful are oncologists in identifying patient distress, perceived social support, and need for psychosocial counselling? Br J Cancer 2001;84:179–85CrossRefGoogle ScholarPubMed
11DiMatteo, MR, Lepper, HS, Croghan, TW. Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med 2000;160:2101–7CrossRefGoogle ScholarPubMed
12Jenkins, C, Carmody, TJ, Rush, AJ. Depression in radiation oncology patients: a preliminary evaluation. J Affect Disord 1998;50:17–21CrossRefGoogle ScholarPubMed
13Oskam, IM, Verdonck-de Leeuw, IM, Aaronson, NK, Kuik, DJ, de Bree, R, Doornaert, P et al. Quality of life as predictor of survival: a prospective study on patients treated with combined surgery and radiotherapy for advanced oral and oropharyngeal cancer. Radiother Oncol 2010;97:258–62CrossRefGoogle ScholarPubMed
14Allison, PJ, Nicolau, B, Edgar, L, Archer, J, Black, M, Hier, M. Teaching head and neck cancer patients coping strategies: results of a feasibility study. Oral Oncol 2004;40:538–44CrossRefGoogle ScholarPubMed
15Katz, MR, Irish, JC, Devins, GM. Development and pilot testing of a psychoeducational intervention for oral cancer patients. Psychooncology 2004;13:642–53CrossRefGoogle ScholarPubMed
16Petticrew, M, Bell, R, Hunter, D. Influence of psychological coping on survival and recurrence in people with cancer: systematic review. BMJ 2002;325:1066CrossRefGoogle ScholarPubMed
17Semple, CJ, Dunwoody, L, Kernohan, WG, McCaughan, E. Development and evaluation of a problem-focused psychosocial intervention for patients with head and neck cancer. Support Care Cancer 2009;17:379–88CrossRefGoogle ScholarPubMed
18Sheard, T, Maguire, P. The effect of psychological interventions on anxiety and depression in cancer patients: results of two meta-analyses. Br J Cancer 1999;80:1770–80CrossRefGoogle ScholarPubMed
19Zigmond, AS, Snaith, RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67:361–70CrossRefGoogle ScholarPubMed
20Rampling, T, King, H, Mais, KL, Humphris, GM, Swindell, R, Sykes, A et al. Quality of life measurement in the head and neck cancer radiotherapy clinic: is it feasible and worthwhile? Clin Oncol (R Coll Radiol) 2003;15:205–10CrossRefGoogle ScholarPubMed
21Bjelland, I, Dahl, AA, Haug, TT, Neckelmann, D. The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res 2002;52:69–77CrossRefGoogle ScholarPubMed
22Chen, AM, Jennelle, RL, Grady, V, Tovar, A, Bowen, K, Simonin, P et al. Prospective study of psychosocial distress among patients undergoing radiotherapy for head and neck cancer. Int J Radiat Oncol Biol Phys 2009;73:187–93CrossRefGoogle ScholarPubMed
23Espie, CA, Freedlander, E, Campsie, LM, Soutar, DS, Robertson, AG. Psychological distress at follow-up after major surgery for intra-oral cancer. J Psychosom Res 1989;33:441–8CrossRefGoogle ScholarPubMed
24Griffiths, GO, Parmar, MK, Bailey, AJ. Physical and psychological symptoms of quality of life in the CHART randomised trial in head and neck cancer: short-term and long-term patient reported symptoms. CHART Steering Committee. Continuous hyperfractionated accelerated radiotherapy. Br J Cancer 1999;81:1196–205CrossRefGoogle Scholar
25Hammerlid, E, Bjordal, K, Ahlner-Elmqvist, M, Jannert, M, Kaasa, S, Sullivan, M et al. Prospective, longitudinal quality-of-life study of patients with head and neck cancer: a feasibility study including the EORTC QLQ-C30. Otolaryngol Head Neck Surg 1997;116:666–73CrossRefGoogle ScholarPubMed
26Hammerlid, E, Ahlner-Elmqvist, M, Bjordal, K, Biorklund, A, Evensen, J, Boysen, M et al. A prospective multicentre study in Sweden and Norway of mental distress and psychiatric morbidity in head and neck cancer patients. Br J Cancer 1999;80:766–74CrossRefGoogle ScholarPubMed
27Hammerlid, E, Silander, E, Hornestam, L, Sullivan, M. Health-related quality of life three years after diagnosis of head and neck cancer – a longitudinal study. Head Neck 2001;23:113–253.0.CO;2-W>CrossRefGoogle ScholarPubMed
28Elani, HW, Allison, PJ. Coping and psychological distress among head and neck cancer patients. Support Care Cancer 2011;19:1735–41CrossRefGoogle ScholarPubMed
29Horney, DJ, Smith, HE, McGurk, M, Weinman, J, Herold, J, Altman, K et al. Associations between quality of life, coping styles, optimism, and anxiety and depression in pretreatment patients with head and neck cancer. Head Neck 2010;33:65–71CrossRefGoogle Scholar
30Hutton, JM, Williams, M. An investigation of psychological distress in patients who have been treated for head and neck cancer. Br J Oral Maxillofac Surg 2001;39:333–9CrossRefGoogle ScholarPubMed
31Kelly, C, Paleri, V, Downs, C, Shah, R. Deterioration in quality of life and depressive symptoms during radiation therapy for head and neck cancer. Otolaryngol Head Neck Surg 2007;136:108–11CrossRefGoogle ScholarPubMed
32Neilson, KA, Pollard, AC, Boonzaier, AM, Corry, J, Castle, DJ, Mead, KR et al. Psychological distress (depression and anxiety) in people with head and neck cancers. Med J Aust 2010;193(suppl 5):S48–51CrossRefGoogle ScholarPubMed
33Pandey, M, Devi, N, Thomas, BC, Kumar, SV, Krishnan, R, Ramdas, K. Distress overlaps with anxiety and depression in patients with head and neck cancer. Psychooncology 2007;16:582–6CrossRefGoogle ScholarPubMed
34Rose, P, Yates, P. Quality of life experienced by patients receiving radiation treatment for cancers of the head and neck. Cancer Nurs 2001;24:255–63CrossRefGoogle ScholarPubMed
35Takahashi, T, Hondo, M, Nishimura, K, Kitani, A, Yamano, T, Yanagita, H et al. Evaluation of quality of life and psychological response in cancer patients treated with radiotherapy. Radiat Med 2008;26:396–401CrossRefGoogle ScholarPubMed
36Verdonck-de Leeuw, IM, Eerenstein, SE, Van der Linden, MH, Kuik, DJ, de Bree, R, Leemans, CR. Distress in spouses and patients after treatment for head and neck cancer. Laryngoscope 2007;117:238–41CrossRefGoogle ScholarPubMed
37Ho, KF, Farnell, DJ, Routledge, JA, Burns, MP, Sykes, AJ, Slevin, NJ et al. Comparison of patient-reported late treatment toxicity (LENT-SOMA) with quality of life (EORTC QLQ-C30 and QLQ-H&N35) assessment after head and neck radiotherapy. Radiother Oncol 2010;97:270–5CrossRefGoogle ScholarPubMed
38Anonymous. LENT SOMA tables. Radiother Oncol 1995;35:17–60CrossRefGoogle Scholar
39Davidson, SE, Trotti, A, Ataman, OU, Seong, J, Lau, FN, da Motta, NW et al. Improving the capture of adverse event data in clinical trials: the role of the International Atomic Energy Agency. Int J Radiat Oncol Biol Phys 2007;69:1218–21CrossRefGoogle ScholarPubMed
40Ho, KF, Farnell, DJ, Routledge, JA, Burns, MP, Sykes, AJ, Slevin, NJ et al. Developing a CTCAEs patient questionnaire for late toxicity after head and neck radiotherapy. Eur J Cancer 2009;45:1992–8CrossRefGoogle ScholarPubMed
41Morse, R, Kendell, K, Barton, S. Screening for depression in people with cancer: the accuracy of the hospital anxiety and depression scale. Clin Eff Nurs 2005;9:188–96CrossRefGoogle Scholar
42Sellick, SM, Edwardson, AD. Screening new cancer patients for psychological distress using the hospital anxiety and depression scale. Psychooncology 2007;16:534–42CrossRefGoogle ScholarPubMed
43Passik, SD, Dugan, W, McDonald, MV, Rosenfeld, B, Theobald, DE, Edgerton, S. Oncologists' recognition of depression in their patients with cancer. J Clin Oncol 1998;16:1594–600CrossRefGoogle ScholarPubMed