Depressive symptoms in relation to overall survival in people with head and neck cancer: A longitudinal cohort study

Femke Jansen, Irma M. Verdonck-de Leeuw, Pim Cuijpers, C. René Leemans, Tim Waterboer, Michael Pawlita, Chris Penfold, Steven J. Thomas, Andrea Waylen, Andrew R. Ness

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objective: The objective of the study is to investigate the relation between pretreatment depressive symptoms (DS) and the course of DS during the first year after cancer diagnosis, and overall survival among people with head and neck cancer (HNC). Methods: Data from the Head and Neck 5000 prospective clinical cohort study were used. Depressive symptoms were measured using the Hospital Anxiety and Depression Scale (HADS) pretreatment, at 4 and 12-month follow-up. Also, socio-demographic, clinical, lifestyle, and mortality data were collected. The association between before start of treatment DS (HADS-depression > 7) and course (never DS, recovered from DS, or persistent/recurrent/late DS at 12-month follow-up) and survival was investigated using Cox regression. Unadjusted and adjusted analyses were performed. Results: In total, 384 of the 2144 persons (18%) reported pretreatment DS. Regarding DS course, 63% never had DS, 16% recovered, and 20% had persistent/recurrent/late DS. People with pretreatment DS had a higher risk of earlier death than people without DS (hazard ratio (HR) = 1.65; 95% confidence interval (CI) 1.33-2.05), but this decreased after correcting for socio-demographic, clinical, and lifestyle-related factors (HR = 1.21; 95% CI 0.97-1.52). Regarding the course of DS, people with persistent/recurrent/late DS had a higher risk of earlier death (HR = 2.04; 95% CI 1.36-3.05), while people who recovered had a comparable risk (HR = 1.12; 95% CI 0.66-1.90) as the reference group who never experienced DS. After correcting for socio-demographic and clinical factors, people with persistent/recurrent/late DS still had a higher risk of earlier death (HR = 1.66; 95% CI 1.09-2.53). Conclusions: Pretreatment DS and persistent/recurrent/late DS were associated with worse survival among people with HNC.

Original languageEnglish
Pages (from-to)2245-2256
Number of pages12
JournalPsycho-Oncology
Volume27
Issue number9
DOIs
Publication statusPublished - 1 Sep 2018

Cite this

Jansen, Femke ; Verdonck-de Leeuw, Irma M. ; Cuijpers, Pim ; Leemans, C. René ; Waterboer, Tim ; Pawlita, Michael ; Penfold, Chris ; Thomas, Steven J. ; Waylen, Andrea ; Ness, Andrew R. / Depressive symptoms in relation to overall survival in people with head and neck cancer : A longitudinal cohort study. In: Psycho-Oncology. 2018 ; Vol. 27, No. 9. pp. 2245-2256.
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title = "Depressive symptoms in relation to overall survival in people with head and neck cancer: A longitudinal cohort study",
abstract = "Objective: The objective of the study is to investigate the relation between pretreatment depressive symptoms (DS) and the course of DS during the first year after cancer diagnosis, and overall survival among people with head and neck cancer (HNC). Methods: Data from the Head and Neck 5000 prospective clinical cohort study were used. Depressive symptoms were measured using the Hospital Anxiety and Depression Scale (HADS) pretreatment, at 4 and 12-month follow-up. Also, socio-demographic, clinical, lifestyle, and mortality data were collected. The association between before start of treatment DS (HADS-depression > 7) and course (never DS, recovered from DS, or persistent/recurrent/late DS at 12-month follow-up) and survival was investigated using Cox regression. Unadjusted and adjusted analyses were performed. Results: In total, 384 of the 2144 persons (18{\%}) reported pretreatment DS. Regarding DS course, 63{\%} never had DS, 16{\%} recovered, and 20{\%} had persistent/recurrent/late DS. People with pretreatment DS had a higher risk of earlier death than people without DS (hazard ratio (HR) = 1.65; 95{\%} confidence interval (CI) 1.33-2.05), but this decreased after correcting for socio-demographic, clinical, and lifestyle-related factors (HR = 1.21; 95{\%} CI 0.97-1.52). Regarding the course of DS, people with persistent/recurrent/late DS had a higher risk of earlier death (HR = 2.04; 95{\%} CI 1.36-3.05), while people who recovered had a comparable risk (HR = 1.12; 95{\%} CI 0.66-1.90) as the reference group who never experienced DS. After correcting for socio-demographic and clinical factors, people with persistent/recurrent/late DS still had a higher risk of earlier death (HR = 1.66; 95{\%} CI 1.09-2.53). Conclusions: Pretreatment DS and persistent/recurrent/late DS were associated with worse survival among people with HNC.",
keywords = "Cancer, Depression, Depressive symptoms, Head and neck cancer, Mortality, Oncology, Survival",
author = "Femke Jansen and {Verdonck-de Leeuw}, {Irma M.} and Pim Cuijpers and Leemans, {C. Ren{\'e}} and Tim Waterboer and Michael Pawlita and Chris Penfold and Thomas, {Steven J.} and Andrea Waylen and Ness, {Andrew R.}",
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Jansen, F, Verdonck-de Leeuw, IM, Cuijpers, P, Leemans, CR, Waterboer, T, Pawlita, M, Penfold, C, Thomas, SJ, Waylen, A & Ness, AR 2018, 'Depressive symptoms in relation to overall survival in people with head and neck cancer: A longitudinal cohort study' Psycho-Oncology, vol. 27, no. 9, pp. 2245-2256. https://doi.org/10.1002/pon.4816

Depressive symptoms in relation to overall survival in people with head and neck cancer : A longitudinal cohort study. / Jansen, Femke; Verdonck-de Leeuw, Irma M.; Cuijpers, Pim; Leemans, C. René; Waterboer, Tim; Pawlita, Michael; Penfold, Chris; Thomas, Steven J.; Waylen, Andrea; Ness, Andrew R.

In: Psycho-Oncology, Vol. 27, No. 9, 01.09.2018, p. 2245-2256.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Depressive symptoms in relation to overall survival in people with head and neck cancer

T2 - A longitudinal cohort study

AU - Jansen, Femke

AU - Verdonck-de Leeuw, Irma M.

AU - Cuijpers, Pim

AU - Leemans, C. René

AU - Waterboer, Tim

AU - Pawlita, Michael

AU - Penfold, Chris

AU - Thomas, Steven J.

AU - Waylen, Andrea

AU - Ness, Andrew R.

PY - 2018/9/1

Y1 - 2018/9/1

N2 - Objective: The objective of the study is to investigate the relation between pretreatment depressive symptoms (DS) and the course of DS during the first year after cancer diagnosis, and overall survival among people with head and neck cancer (HNC). Methods: Data from the Head and Neck 5000 prospective clinical cohort study were used. Depressive symptoms were measured using the Hospital Anxiety and Depression Scale (HADS) pretreatment, at 4 and 12-month follow-up. Also, socio-demographic, clinical, lifestyle, and mortality data were collected. The association between before start of treatment DS (HADS-depression > 7) and course (never DS, recovered from DS, or persistent/recurrent/late DS at 12-month follow-up) and survival was investigated using Cox regression. Unadjusted and adjusted analyses were performed. Results: In total, 384 of the 2144 persons (18%) reported pretreatment DS. Regarding DS course, 63% never had DS, 16% recovered, and 20% had persistent/recurrent/late DS. People with pretreatment DS had a higher risk of earlier death than people without DS (hazard ratio (HR) = 1.65; 95% confidence interval (CI) 1.33-2.05), but this decreased after correcting for socio-demographic, clinical, and lifestyle-related factors (HR = 1.21; 95% CI 0.97-1.52). Regarding the course of DS, people with persistent/recurrent/late DS had a higher risk of earlier death (HR = 2.04; 95% CI 1.36-3.05), while people who recovered had a comparable risk (HR = 1.12; 95% CI 0.66-1.90) as the reference group who never experienced DS. After correcting for socio-demographic and clinical factors, people with persistent/recurrent/late DS still had a higher risk of earlier death (HR = 1.66; 95% CI 1.09-2.53). Conclusions: Pretreatment DS and persistent/recurrent/late DS were associated with worse survival among people with HNC.

AB - Objective: The objective of the study is to investigate the relation between pretreatment depressive symptoms (DS) and the course of DS during the first year after cancer diagnosis, and overall survival among people with head and neck cancer (HNC). Methods: Data from the Head and Neck 5000 prospective clinical cohort study were used. Depressive symptoms were measured using the Hospital Anxiety and Depression Scale (HADS) pretreatment, at 4 and 12-month follow-up. Also, socio-demographic, clinical, lifestyle, and mortality data were collected. The association between before start of treatment DS (HADS-depression > 7) and course (never DS, recovered from DS, or persistent/recurrent/late DS at 12-month follow-up) and survival was investigated using Cox regression. Unadjusted and adjusted analyses were performed. Results: In total, 384 of the 2144 persons (18%) reported pretreatment DS. Regarding DS course, 63% never had DS, 16% recovered, and 20% had persistent/recurrent/late DS. People with pretreatment DS had a higher risk of earlier death than people without DS (hazard ratio (HR) = 1.65; 95% confidence interval (CI) 1.33-2.05), but this decreased after correcting for socio-demographic, clinical, and lifestyle-related factors (HR = 1.21; 95% CI 0.97-1.52). Regarding the course of DS, people with persistent/recurrent/late DS had a higher risk of earlier death (HR = 2.04; 95% CI 1.36-3.05), while people who recovered had a comparable risk (HR = 1.12; 95% CI 0.66-1.90) as the reference group who never experienced DS. After correcting for socio-demographic and clinical factors, people with persistent/recurrent/late DS still had a higher risk of earlier death (HR = 1.66; 95% CI 1.09-2.53). Conclusions: Pretreatment DS and persistent/recurrent/late DS were associated with worse survival among people with HNC.

KW - Cancer

KW - Depression

KW - Depressive symptoms

KW - Head and neck cancer

KW - Mortality

KW - Oncology

KW - Survival

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U2 - 10.1002/pon.4816

DO - 10.1002/pon.4816

M3 - Article

VL - 27

SP - 2245

EP - 2256

JO - Psycho-Oncology

JF - Psycho-Oncology

SN - 1057-9249

IS - 9

ER -