Depression and related factors after oral oncological treatment: a 5-year prospective cohort study

Caroline M. Speksnijder,Anton F. J. de Haan,Matthias A. W. Merkx,Ron Koole,Remco de Bree,Petra J. M. Lankhorst

doi:10.1007/s00520-020-05795-1

Abstract

PurposesBeing diagnosed with oral cancer is a life-threatening life event. It often induces social, emotional and psychological consequences and may cause depressive disorders. The primary aim of this study was to identify and quantify the personal and clinical characteristics involved in depression for patients who have been treated for oral cavity malignancies, with a 5-year follow-up period after treatment. The secondary aim of this study was to identify the clinical factors that increase a patient’s risk of experiencing depression 5 years after treatment.MethodsPatients with primary oral cancer were assessed for up to 5 years after primary treatment. A mixed-model analysis was performed, with depression measured by the Center for Epidemiologic Studies Depression Scale as outcome measure.ResultsA total of 141 patients were included in the study. Factors associated with depression were gender, tumour location and having an emotion-oriented coping style. The occurrence of depression within 5 years after treatment could be reliably predicted by a patient’s gender, the location of their tumour and the extent to which they had an emotion-oriented coping style.ConclusionsThis study revealed that being female, having a maxillary tumour and having an emotion-oriented coping style are associated with higher levels of depressive symptoms in patients treated for oral cancer up to 5 years post-treatment. A substantial proportion of the patients with oral cancer experienced high levels of depression both before and after their treatment, suggesting that adequate diagnostics and care are needed to try to prevent severe depression in these patients.

Highlights

Head and neck cancers are among the top ten most common causes of cancer-related deaths worldwide [1]
The oncological curative treatment of early-stage oral tumours usually involves surgery on indication, followed by radiotherapy and/or chemotherapy; these treatments and the resulting oral function deficits are associated with depression rates of 18% to 41% in patients treated for oral cancer [6,7,8,9,10]
The tertiary aim was to identify and quantify the personal characteristics involved in depression in healthy persons. In this multi-centre prospective cohort research, the study population consisted of patients with a primary malignant tumour involving the oral cavity who were referred to the University Medical Center Utrecht (UMCU) or Radboud University Medical Center (Radboudumc) between January 2007 and August 2009

Summary

Introduction

Head and neck cancers are among the top ten most common causes of cancer-related deaths worldwide [1]. In the Netherlands, patients with oral cancer comprised of 28% of all patients with head and neck cancer [2]. Being diagnosed with oral cancer is a life-threatening life event. It often induces social, emotional and psychological consequences and may be associated with depressive disorders [3]. Depression is a common mental disorder in all patients with cancer [4]. In 2011, a meta-analysis was conducted on 66 studies to determine the prevalence of depression in people with cancer, revealing that major depression was reported in 16.3% (95% CI: 13–20%) of these patients [5]

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