Depressive symptoms and perceived stress in patients with head and neck cancer undergoing intensity-modulated radiation therapy: A longitudinal study.
Jieun Oh, Qingyang Hu, Fan Fei and 4 others
PMID 42217521WHAT IT FOUND
Depressive symptoms rose to end of IMRT and stayed near baseline after treatment.
Perceived stress did not rise at end but fell at 6 and 12 months. Unmarried status and PEG tube use marked higher risk.
Key findings
01Depressive symptoms increased from baseline to end of IMRT by 4.62 points on the 0 to 24 PHQ-8, about 19% increase. At 6 months and 1 year, changes were not significant and symptoms stayed near baseline.
02The proportion with clinically significant depressive symptoms was 12.7% before IMRT, 34.0% at end of IMRT, 9.64% at 6 months, and 9.14% at 12 months.
03Unmarried patients scored 2.27 PHQ-8 points higher than married patients and 4.42 PSS points higher than married patients. PEG tube use was associated with 1.72 additional PHQ-8 points and 2.58 additional PSS points.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was a secondary analysis of data collected about ten years ago, and head and neck cancer treatment has changed since then. There was approximately 37% attrition by the final time point, with 30% to 40% missing data at 6 months and 1 year. The sample was not highly diverse and included many non-Hispanic White males, so the findings may not apply to more diverse populations. No a priori sample size calculation was conducted. GEE models estimate population-averaged effects and may miss individual symptom trajectories. Important variables such as specific chemotherapy regimens, treatment-related physical symptoms, coping styles, and social support levels were not included and could confound the associations. Depressive symptoms and stress were self-reported and may be affected by recall bias.
Declared interests
The authors declare no conflicts of interest. They state the research was conducted independently and no commercial or financial relationships influenced the study design, data collection, analysis, or interpretation. External funding sources had no role in the study design, data collection, analysis, interpretation, or manuscript writing.
The easy way to misread this
Do not read the 34.0% clinically significant depressive symptoms at end of IMRT as proof that IMRT causes depression. This was an observational analysis, not a treatment trial, and patients also had surgery, chemotherapy, or PEG tubes.