Anxiety, Depression and Cancer-Related Post-Traumatic Stress in Patients Undergoing Total Laryngectomy

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY Laryngoscope Investigative Otolaryngology Pub Date : 2025-03-04 DOI:10.1002/lio2.70109

Mai Yokoi, Naoki Nishio, Hiroyuki Kimura, Tatsuya Tokura, Shinichi Kishi, Hidenori Tsuzuki, Nobuaki Mukoyama, Sayaka Yokoi, Akihisa Wada, Mayu Shigeyama, Yasushi Fujimoto, Masashi Ikeda, Michihiko Sone

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Abstract

Purpose

This study aims to elucidate the incidence of cancer-related post-traumatic stress (PTS) and the fluctuations in anxiety and depression levels before and one year after laryngectomy.

Methods

A prospective longitudinal study was conducted on 97 consecutive patients scheduled to undergo laryngectomy (total laryngectomy or pharyngolaryngectomy) at a single university hospital between 2007 and 2022. To assess cancer-related PTS, anxiety, and depression, participants completed two brief self-reported questionnaires: the Impact of Event Scale-Revised (IES-R) and the Hospital Anxiety and Depression Scale (HADS).

Results

Prior to laryngectomy, 32 patients planning for the procedure were considered as cancer-related PTS based on IES-R. The prevalence of anxiety and depression before surgery was 56% and 76% in the 32 patients with PTS, respectively, compared to 8% and 20% in the 65 patients without PTS. Patients with PTS exhibited significantly worse HADS-anxiety and HADS-depression scores compared to those without PTS at baseline (p < 0.001 for both). Although no significant difference was found in the HADS-anxiety score between the two groups (p = 0.15), patients with PTS exhibited a significantly worse HADS-depression score than those without PTS one year after surgery (p = 0.03).

Conclusion

Early identification of possible depressive disorders and active psychiatric interventions are crucial for patients undergoing laryngectomy during the follow-up period. Preoperative assessment of cancer-related PTS may offer an opportunity to implement appropriate psychological interventions.

Level of Evidence

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全喉切除术患者的焦虑、抑郁和癌症相关创伤后应激

目的探讨喉切除术前及术后1年癌症相关创伤后应激（PTS）的发生率及焦虑、抑郁水平的波动。方法对2007年至2022年在同一所大学医院连续行喉切除术（全喉切除术或咽喉切除术）的97例患者进行前瞻性纵向研究。为了评估与癌症相关的PTS、焦虑和抑郁，参与者完成了两份简短的自我报告问卷：事件量表修订的影响（IES-R）和医院焦虑和抑郁量表（HADS）。结果在喉切除术前，32例计划手术的患者根据IES-R被认为是癌症相关的PTS。32例PTS患者术前焦虑和抑郁患病率分别为56%和76%，而65例无PTS患者术前焦虑和抑郁患病率分别为8%和20%。与基线时没有PTS的患者相比，PTS患者表现出更差的hads -焦虑和hads -抑郁评分（p < 0.001）。尽管两组患者的hads -焦虑评分无显著差异（p = 0.15），但术后1年，PTS患者的hads -抑郁评分明显低于无PTS患者（p = 0.03）。结论在喉切除术患者的随访过程中，早期发现可能的抑郁障碍并采取积极的精神干预措施至关重要。术前评估癌症相关PTS可能为实施适当的心理干预提供机会。证据级别4。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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