Contextual and historical factors for increased levels of anxiety and depression in patients with head and neck cancer: A prospective longitudinal study

BACKGROUND: This study aimed at examining predictors of clinical anxiety and depressive symptoms in patients with head and neck cancer (HNC) at 3, 6, and 12 months post-diagnosis, with a particular interest in contextual and historical factors. METHODS: Prospective longitudinal study of 219 consecutive patients newly diagnosed with a first occurrence of primary HNC, including psychometric measures, Structured Clinical Interview for DSM-IV Diagnoses (SCID), and medical chart reviews. RESULTS: Point prevalence of clinical anxiety symptoms (Hospital Anxiety and Depression Scale-Anxiety subscale) was 32.0%, 21.9%, 12.1%, and 12.6% at baseline, 3, 6, and 12 months; and clinical depressive symptoms on the Depression Subscale was 19.4%, 21.9%, 13.5%, and 9.2%, respectively. Predictors of anxiety and depressive symptoms included upon diagnosis SCID major depressive or anxiety disorder, stressful life events in previous year, neuroticism, and levels of anxiety and depressive symptoms upon cancer diagnosis. CONCLUSIONS: This study emphasizes the predictive contribution of broader personal contextual and historical factors that increase psychological vulnerability in HNC and merit consideration.