(0619) Characterizing Anxiety and Depression in Head and Neck Cancer Patients

Introduction: Depression and anxiety are associated with increased adverse outcomes worse survival for head and neck cancer patients. This study seeks to understand the patient and treatment factors associated with posttreatment depression and anxiety and thereby identify those most likely to be affected by it.

Methods: Data was collected on all patients seen in a survivorship clinic for head and neck cancer who underwent surgery with or without adjuvant treatment from 2016-2022. Posttreatment measures of anxiety and depression were collected using the Patient Health Questionnaire 8 (PHQ-8) and General Anxiety Disorder-7 (GAD-7). Patients were categorized as depressed if they reported PHQ-8 > 4 and anxious if they reported GAD-7 > 4.

Results: A total of 248 patients met these criteria and completed both PHQ-8 and GAD-7. For all patients, the prevalence of at least mild depression was 45.2% and 29.8% reported at least mild anxiety. Female patients were significantly more likely than their male peers to report at least mild posttreatment anxiety (44.7% vs 21.9%; p = 0.0002) and depression (63.5% vs 35.4%; p < 0.0001). Patients identifying as Black experienced greater rates of depression (77.8% vs 43.6%; p = 0.043) than their White peers. Patients requiring post-treatment free flap reconstruction demonstrated significantly increased rates of depression (51.1% vs 36.9% without; p = 0.026) and increased depression severity (mean PHQ-8 SD 6.6 ± 5.3 vs 5.2 ± 4.7 without; p = 0.03).

Conclusions: From this study, we can infer that head and neck cancer patients who are female, Black, or had surgical reconstruction of their cancer site would be most likely to benefit from early postoperative behavioral health evaluation and treatment.