Approximately 40% of patients develop major depressive disorder (MDD) during diagnosis and treatment for head and neck cancer (HNC). Depressive symptoms in these patients have a significant effect on their rehabilitation and survival. Given the small number of studies in the literature, and degree of heterogeneity in these studies, it is difficult to illustrate the association between depression and survival in patients with HNC. Authors in this systematic literature search included three articles including a total of 431 patients. In each of the three studies used in the analysis, the comparison groups were depressed and non-depressed patients as established by a standardised psychiatric assessment tool. Two of the three studies demonstrated a statistically significant difference in survival for patients with HNC and depression. An association between depression and survival in patients with HNC is apparent but further studies are required to investigate this association and determine appropriate screening and management strategies. Depression is increasingly recognised as an important comorbidity for identification and treatment in individuals with cancer. International organisations have indicated that screening for and treating psychosocial conditions should be integrated into cancer care. Routine surveillance for depression in individuals with cancer may allow an improved understanding of its effects on survival and other functional outcomes. 

Depression and survival in patients with head and neck cancer: a systematic review.
Barber B, Dergousoff J, Slater L, et al.
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Shabbir Akhtar

Department of Surgery, The Aga Khan University and Hospital, Karachi, Pakistan.

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