Source: www.healio.com
Author: Allen Chen

Despite high rates of depression among individuals with head and neck cancers after radiation therapy, mental health services are severely underutilized in this patient population, results of a cross-sectional analysis suggest.

Allen M. Chen, MD, of the department of radiation oncology at the David Geffen School of Medicine at UCLA, and colleagues evaluated data on 211 patients with squamous cell carcinoma of the head and neck. All patients underwent radiation therapy and were disease-free within at least 1 year of follow-up. Exclusion criteria included history of mood disorder, previous use of mental health services, or use of antidepressants or anxiolytics, not including sleep medications.

The researchers pooled data from self-administered questionnaires to assess depression rates in these patients. The following scores were assigned to subjective responses of mood: 0, extremely depressed; 25, somewhat depressed; 50, neither in a good mood nor depressed; 75, generally good; and 100, excellent.

Results suggested no differences in mean mood scores at 1 year (52), 3 years (55.7) or 5 years (62.1) after treatment. The presence of tracheostomy tube or laryngeal stoma (P=.01), gastrostomy tube dependence (P=.01) and continued smoking at the time of follow-up (P< .001) were significantly associated with depression after radiation therapy. At 1-year follow-up, 17% of patients reported their mood as “somewhat depressed” or “extremely depressed.” The rate was 15% at 3 years and 13% at 5 years. However, the percentage of patients who reported use of antidepressants was 6% at 1 year, 11% at 3 years and 0% at 5 years, whereas the rate of patients who reported actively seeking or undergoing counseling was 3% at 1 year, 6% at 3 years and 0% at 5 years. “This research points to a sorely unmet need for psychosocial services among these cancer survivors and significant underutilization of mental health resources by head and neck cancer patients for their depression,” Chen said in a press release. “This is important because research has shown that suicide rates among cancer patients can be up to 10 times higher than the general population. More studies with longer follow-up are needed to assess the potential impact of depression on quality of life for these patients to understand why they are not getting the help they need, and to determine what interventions can bridge this divide in the future.” Source: Chen AM. JAMA Otolaryngol Heart Surg 2013;doi:10.1001/jamaoto.2013.4072.