Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA.
Laryngoscope. 2011 Jun;121(6):1212-8. doi: 10.1002/lary.21788. Epub 2011 May 3.
To determine the incidence of depression in head and neck cancer (HNCA) patients and the effect of depression on baseline head- and neck-specific measures of quality of life and function.
Prospective cohort analysis.
A total of 255 patients were prospectively evaluated using the Beck Depression Inventory Fast-Screen (BDI-FS) survey, University of Washington Quality of Life (UW QOL), Voice Handicap Index (VHI), and MD Anderson Dysphagia Inventory (MDADI) questionnaires. Patients with a preexisting diagnosis of depression were excluded.
Complete data were available for 77 patients with HNCA and 53 controls. Depressive symptoms were identified in 9% of controls and 19% of HNCA patients, and were significantly associated with a HNCA diagnosis (OR = 4.1, P = .044). Among patients with HNCA, depression was significantly more common in black patients (OR = 15.8, P = .017). A significant negative correlation was found between BDI-FS score and UW global QOL score (r = -0.4, P = .0019). Depression was significantly associated with poorer UW global QOL (β = -22.46, P = .0004), recreation (β = -13.77, P = .037), speech (β = -24.05, P = .004), and MDADI functional (β = -17.31, P = .009), physical (β = -14.99, P = .032), and emotional (β = -11.60, P = .049) domain scores but not with other UW QOL or VHI domains, after controlling for all other variables.
Patients with HNCA have a high incidence of depressive symptoms at diagnosis, which is significantly higher in black patients, and is associated with poorer QOL and MDADI scores. Pretreatment depression may serve as a marker for patients with increased risk of swallowing impairment and reduced QOL who would benefit from targeted intervention.
确定头颈部癌症（HNCA）患者中抑郁的发生率，以及抑郁对头颈部特定生活质量和功能基线测量的影响。
前瞻性队列分析。
共对 255 例患者进行前瞻性评估，采用贝克抑郁量表快速筛查（BDI-FS）、华盛顿大学生活质量（UW QOL）、嗓音障碍指数（VHI）和 MD 安德森吞咽障碍指数（MDADI）问卷。排除有抑郁既往诊断的患者。
共有 77 例 HNCA 患者和 53 例对照者完成了完整的数据。对照组中出现抑郁症状的比例为 9%，HNCA 患者为 19%，HNCA 诊断与抑郁显著相关（OR=4.1，P=.044）。在 HNCA 患者中，黑种人患者中抑郁更为常见（OR=15.8，P=.017）。BDI-FS 评分与 UW 总体生活质量评分呈显著负相关（r=-0.4，P=.0019）。抑郁与 UW 总体生活质量（β=-22.46，P=.0004）、娱乐（β=-13.77，P=.037）、言语（β=-24.05，P=.004）以及 MDADI 功能（β=-17.31，P=.009）、躯体（β=-14.99，P=.032）和情绪（β=-11.60，P=.049）领域评分显著相关，而与其他 UW QOL 或 VHI 领域评分无关，在控制所有其他变量后仍如此。
HNCA 患者在诊断时即存在高发生率的抑郁症状，在黑种人患者中更为显著，与生活质量和 MDADI 评分更差相关。治疗前的抑郁可能是吞咽障碍和生活质量受损风险增加的患者的一个标志物，这些患者可能从针对性干预中受益。
