Prevalence and sociodemographic factors associated with depression among hospitalized patients with head and neck cancer—results from a national study
Menée aux Etats-Unis à partir de données portant sur 71 541 patients hospitalisés pour un cancer de la tête et du cou diagnostiqué entre 2008 et 2013, cette étude rétrospective analyse les facteurs sociodémographiques et cliniques associés à la présence de symptômes dépressifs
Objective : Depression is a significant problem for patients with head and neck cancer (HNC). This study explored the prevalence of, and sociodemographic and clinical factors associated with, depression, among patients with HNC. Methods : We performed a retrospective analysis of 71,541 cases of HNC using a national dataset, the Nationwide Inpatient Sample 2008–2013 data. Weighted, multivariate logistic regression analysis estimated association between sociodemographic/clinical factors and tumor anatomical site with diagnosis of a major depressive disorder. Results : Overall prevalence of major depressive disorder in HNC was 9.3%; highest prevalence was found in patients with laryngeal cancer (28.5%). Compared with laryngeal cancer, there were lower odds of depression among patients with oral cavity cancer (aOR = 0.90, 95% CI: 0.84 – 0.97), and other anatomic sites (aOR = 0.87; 95% CI: 0.81 – 0.94), except oropharyngeal cancer (aOR = 1.00; 95% CI: 0.93 – 1.08). For every unit increase in comorbidities, odds of depression increased by 20% (aOR = 1.20; 95% CI: 1.19 – 1.23). Sociodemographic factors associated with increased odds of depression included being female (aOR = 1.77; 95% CI: 1.68 – 1.87), white (aOR = 1.75; 95% CI: 1.59 – 1.92), and having Medicaid (aOR = 1.09; 95% CI: 1.01 – 1.19), or Medicare insurance (aOR = 1.19; 95% CI: 1.10 – 1.27). Conclusions : Depression odds vary depending on HNC anatomic site, and 1-in-4 patients with laryngeal cancer may be depressed. Since depression is prevalent in this survivor cohort, it is important that psychosocial assessment and intervention are integrated into mainstream clinical care for patients with HNC.
Psycho-Oncology 2018