VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Iowa City, Iowa City VA Health Care System, Iowa City, IA, USA.
Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL, USA.
J Psychosoc Oncol. 2022;40(6):868-880. doi: 10.1080/07347332.2021.1971816. Epub 2021 Sep 6.
Problem alcohol use is a risk factor for the development of head and neck cancer (HNC) and continued use is associated with poor outcomes; depressive symptoms may be associated with this behavior.
Exploratory cross-sectional study examined depressive symptoms as a correlate of self-reported problem alcohol use at diagnosis.
SAMPLE/METHODS: Multivariable linear regression examined depressive symptoms as a correlate of problem alcohol use in a sample of rural HNC patients ( = 249).
Over half (55.2%) of rural patients with potentially problem alcohol use exhibited mild to moderate depressive symptomatology. Regression models controlling for age, cancer site, stage, sex, tobacco use, and treatment modality indicated that depressive symptoms at diagnosis were associated with self-reported problem alcohol use scores at diagnosis (ß = .186, sr = .031, < .01). Follow-up subgroup analyses demonstrated that depressive symptoms at diagnosis were significantly associated with self-reported problem alcohol use in male patients, those with advanced stage disease, and of older age.
CONCLUSIONS/IMPLICATIONS: HNC patients should be screened for alcohol use and depression at diagnosis. Access to behavioral health treatment and/or referral options may be lacking in rural areas thus additional ways of connecting rural patients to specialty care should be explored. These may include telehealth and multimodal interventions to address complex behavioral health cases. Additional research in important patient subgroups such as older patients and those presenting with advanced disease is also warranted.
酗酒是头颈部癌症（HNC）发展的一个风险因素，持续酗酒与不良预后相关；抑郁症状可能与这种行为有关。
探索性横断面研究考察了抑郁症状与诊断时自我报告的酗酒问题之间的相关性。
样本/方法：多变量线性回归分析考察了农村 HNC 患者样本中抑郁症状与酗酒问题之间的相关性（n=249）。
超过一半（55.2%）有潜在酗酒问题的农村患者表现出轻度至中度抑郁症状。控制年龄、癌症部位、分期、性别、吸烟和治疗方式的回归模型表明，诊断时的抑郁症状与诊断时自我报告的酗酒问题评分相关（β=0.186，sr=0.031， < 0.01）。随访亚组分析表明，诊断时的抑郁症状与男性患者、晚期疾病患者和年龄较大的患者自我报告的酗酒问题显著相关。
结论/意义：HNC 患者在诊断时应接受酗酒和抑郁的筛查。农村地区可能缺乏行为健康治疗和/或转介选择，因此应探索将农村患者与专业护理联系起来的其他方法。这些可能包括远程医疗和多模式干预措施，以解决复杂的行为健康病例。还需要对重要的患者亚组（如老年患者和晚期疾病患者）进行进一步的研究。
