Depression and tumor stage in cancer of the head and neck

Abstract

Abstract A study was undertaken to explore the relationship between depression and tumor invasiveness in a group of 45 patients with cancer of the head and neck at different stages. Patients were assessed for depression at the time of their first visit to a tertiary care cancer center, before definitive diagnosis was made and treatment initiated. Depression was assessed by using the DSM‐III derived dysthymia scale of the Millon Clinical Multiaxial Inventory and by clinical interview which elicited symptoms of major depression. We hypothesized that if depression were related to the physical effects of the tumor then patients with more advanced cancer would be more depressed due to associated pain, discomfort and nutritional deficits. Contrary to expectations, results showed that depression scores were distributed equally throughout all stages. However, stage × gender analysis showed a significant effect with females having early stage (1 and 2) cancer being most depressed. Physical symptoms and nutritional factors were not associated with depressed affect but marital status (unmarried) and stress scores were. The high frequency of depression reported in head and neck cancer patients is not necessarily the result of the malignant process or a response to treatment but may be related to premorbid factors of which social support is one variable.