Abstract
BackgroundA cancer diagnosis is potentially life-threatening, likely causing distress and uncertainty, which may be psychologically debilitating. Depression and anxiety are commonly underdiagnosed and undertreated in cancer patients. Head and neck cancer (HNC) patients face particular challenges that may contribute to distress. This review aims to: i) identify patient reported outcome measures (PROMs) designed to assess anxiety and depression in HNC; and ii) determine their suitability for use in research and clinical practice to screen patients.MethodsWe searched five electronic databases between July 2007 to July 2019 for studies assessing anxiety and depression in HNC patients. Searches were limited to this period to account for advances in cancer treatment. Records were screened for eligibility by one reviewer and 10% cross-checked by a second across all stages of the review. In addition to the electronic searches, PROM databases were searched for additional measures of anxiety and depression. All retrieved PROMs were mapped against Diagnostic and Statistical Manual-5 criteria for anxiety and depression to assess content coverage. Then, their psychometric properties appraised against the COSMIN checklist.ResultsElectronic searches identified 98 records, from which five anxiety and eight depression measures were retrieved. PROM database searches retrieved an additional four anxiety and four depression measures; a total of nine anxiety and 12 depression measures were appraised. Content coverage of anxiety measures ranged from 50% to 75% and depression measures from 42% to 100%. Demonstration of psychometric properties against COSMIN criteria ranged from 57% to 71% for anxiety measures (three PROMs > 70%) and from 29% to 86% for depression measures (nine PROMs > 70%). Three anxiety and seven depression measures had established clinical cut-offs in cancer populations.ConclusionsThe Patient Health Questionnaire-9, Zung Self-rating Depression and Zung Self-rating Anxiety Scales demonstrated good content coverage along with excellent psychometric properties, and thus were considered the most suitable PROMs to assess psychological distress in HNC populations. It is important to have PROMs assessing psychological distress that capture a comprehensive set of subjective symptoms. The identified PROMs will help researchers and health professionals in clinical-decision making, thereby potentially improving quality of life in HNC patients.
Highlights
A cancer diagnosis is potentially life-threatening, likely causing distress and uncertainty, which may be psychologically debilitating
It is important to have Patient-reported outcome measure (PROM) assessing psychological distress that capture a comprehensive set of subjective symptoms
From included studies and online PROMs databases, a total of nine anxiety and 12 depression measures were retained for further analysis (Fig. 1 details the PRISMA flow diagram)
Summary
A cancer diagnosis is potentially life-threatening, likely causing distress and uncertainty, which may be psychologically debilitating. Diagnosis of any life-threatening illness can result in multiple emotional and psychological reactions. Of all people with cancer, those diagnosed with head and neck cancer (HNC) experience high rates of depression and anxiety during and after treatment [1, 2], due to the location of the cancer and its impact on appearance and critical functions. The physical effects of these cancers may result in social withdrawal and poor emotional expression rendering HNC patients more prone to depression or anxiety than those with other cancers [3–8]. Psychological morbidity could impact patients’ Health Related Quality of Life (HRQoL), limit their social activities, increase their hospital stay, delay their return to work, and influence their ability to care for themselves [10, 11]. Studies have shown that depressed cancer patients are more likely to have disease recurrence and poorer survival [15], making it critically important to recognise and treat depression when it occurs
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
