Increased Risk for Mental Health Disorders Seen With Head and Neck Cancers

The presence of cancer can impact a patient’s mental health, and in turn, prognosis can be influenced by a patient’s mental state.^1,2 Results of a new study shed light on significant relationships between head and neck cancer (HNC) diagnoses and mental health disorders (MHDs).³

The study was a retrospective cohort analysis of the Truven Health MarketScan Commercial Claims and Encounters database records from 52,641 patients, conducted by researchers Ji Hyae Lee, BA, and colleagues from Pennsylvania State University, in Hershey.³

In this study, the researchers explored relationships between HNC and the presence of MHDs prior to and following the HNC diagnosis. Patients were included for whom data were available for at least 1 year prior to HNC diagnosis. The period of time considered for postdiagnosis MHDs was between 90 days and 1 year after HNC diagnosis. MHDs were identified by many possible mental health diagnoses and/or prescriptions for psychotropic treatments.³

Impact of Treatment Morbidities

Among cancers, HNC has been shown to be associated with high rates of depression.⁴ According to Lee and colleagues, although treatments can be effective against HNC, “treatment morbidities can include disfigurement, dysphagia, dysarthria, and tracheostomy and gastric tube dependence, all of which can significantly affect quality of life.”³

The greatest impact on MHDs appeared to relate to treatment for HNC. Patients who were treated with a combination of surgery, chemotherapy, and radiotherapy were much more likely to develop MHDs than were patients treated with only surgery (adjusted odds ratio [OR], 3.69; 95% confidence interval [CI], 3.44-3.96).³

Overall, patients with HNC showed an increase in MHDs following cancer diagnosis, rising to a rate of 29.9% after diagnosis, compared with 20.6% prior to diagnosis. The authors noted that the rate prior to diagnosis was near to the national estimated average of 17.9% but was somewhat higher.³

Women showed a higher tendency to develop MHDs following HNC diagnosis than men did (adjusted OR, 1.58; 95% CI, 1.49-1.67). Other characteristics associated with developing an MHD after HNC diagnosis were alcohol use (adjusted OR, 1.56; 95% CI, 1.38-1.76) and a history of using tobacco (adjusted OR, 1.42; 95% CI, 1.34-1.50).³