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European Archives of Oto-Rhino-Laryngology

, Volume 274, Issue 3, pp 1591–1599 | Cite as

Course of psychiatric comorbidity and utilization of mental health care after laryngeal cancer: a prospective cohort study

  • J. KeszteEmail author
  • H. Danker
  • A. Dietz
  • E. Meister
  • F. Pabst
  • O. Guntinas-Lichius
  • J. Oeken
  • S. Singer
  • A. Meyer
Laryngology

Abstract

In a German multi-center prospective cohort study, we wanted to assess the course of psychiatric comorbidity, utilization of mental health care and psychosocial care needs in laryngeal cancer patients during the first year after partial laryngectomy (PRL). Structured interviews with patients were conducted before surgery, 1 week (1 w), 3 months (3 m) and 1 year (12 m) after PRL. Psychiatric comorbidity was assessed using the Structured Clinical Interview for DSM-IV (SCID). Psychosocial care needs and utilization of mental health care were evaluated with standardized face-to-face interviews. In 176 patients, psychiatric disorders were prevalent in 11 % (1 w), 15 % (3 m) and 14 % (12 m), respectively, of which 4 % (12 m) underwent psychiatric treatment or psychotherapy. Two percent had acute, 15 % emerging and 6 % chronic psychiatric comorbidity. Chronically mental ill patients were more frequently younger than 65 years (p = 0.026), female (p = 0.045) and experienced more often a need for psychological counseling (p ≤ 0.001). One year after surgery, 27 % of the comorbid psychiatric patients expressed a need for additional psychological counseling. Alcohol-related disorders were diagnosed in 3 % (1 w), 3 % (3 m) and 8 % (12 m), respectively. Only one of these patients received psychological treatment, while 14 % expressed a need for psychological counseling and 7 % for additional medical consultations. The non-treatment of alcohol-related disorders measured in our sample indicates a major problem since continued alcohol consumption in laryngeal cancer patients is associated with reduced global quality of life, increased functional impairments and reduced overall survival. Screening instruments integrated into acute care are necessary to detect harmful drinking behavior.

Keywords

Head and neck cancer Transoral surgery Mental health care Oncology Psychosocial care needs Mental disorders 

Notes

Acknowledgments

The study was funded by grants from the German Cancer Aid (#107440, #109604).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was endorsed by the ethics committee of the University of Leipzig Medical Faculty based on the principles of the working group Medical Ethics Committees in Germany. All procedures performed involving human participants were in accordance with the ethical standards of the 1964 Helsinki declaration and its later amendments. All participants provided written informed consent.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  1. 1.Division Psychosocial Oncology, Department of Medical Psychology and Medical SociologyUniversity Medical CenterLeipzigGermany
  2. 2.Department of Otorhinolaryngology and Head and Neck SurgeryUniversity Medical CenterLeipzigGermany
  3. 3.Department of OtorhinolaryngologyClinical Center Sankt GeorgLeipzigGermany
  4. 4.Department of OtorhinolaryngologyClinical Center Dresden-FriedrichstadtDresdenGermany
  5. 5.Department of Otorhinolaryngology and Head and Neck SurgeryUniversity HospitalJenaGermany
  6. 6.Department of OtorhinolaryngologyClinical Center ChemnitzChemnitzGermany
  7. 7.Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and InformaticsUniversity Medical CenterMainzGermany

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