Abstract
Purpose
The purpose of this study is to examine the relationship between body image and depressive symptoms in patients who have been treated for head and neck cancer.
Methods
This is a prospective, longitudinal analysis. Body image and depressive symptoms were measured in patients diagnosed with head and neck cancer at baseline, end of treatment, 6 weeks post-treatment, and 12 weeks post-treatment. Body image was measured using the Body Image Quality of Life Inventory, and depressive symptoms were measured using the Center for Epidemiological Studies Depression Scale.
Results
Forty-three individuals diagnosed with head and neck cancer participated in this study. The majority of participants were male, Caucasian, and married or living with a partner. Participants ranged from age 32 to 78 years (M = 57.8 years, SD = 10.5 years). At 12 weeks post-treatment, body image scores were statistically significantly higher than they were at the end of treatment (p = 0.016) and 6 weeks post-treatment (p = 0.032). Statistically significant increases in levels of depressive symptoms were observed at the end of treatment (p < 0.001) and 6 weeks post-treatment (p = 0.036) with a return to baseline by the 12-week post-treatment assessment (p = 0.115). Body image and depressive symptoms were statistically significantly associated at the end of treatment, 6 weeks post-treatment, and 12 weeks post-treatment (r s −0.32 to −0.56, p < 0.05).
Conclusions
This study supports early assessment of body image in patients with head and neck cancer. Additionally, the association between poorer body image and increased depressive symptoms is key in understanding the symptom clusters that patients with head and neck cancer experience.
Similar content being viewed by others
References
Merriam-Webster (2013) Body image. http://www.merriam-webster.com/medical/bodyimage. Accessed 4 Nov 2013
Rhoten B, Murphy B, Ridner S (2013) Body image in patients with head and neck cancer: a review of the literature. Oral Oncol 49:753–760. doi:10.1016/j.oraloncology.2013.04.005
Merriam-Webster (2013) Disfigure. http://www.merriam-webster.com/dictionary/disfigurement. Accessed 4 Nov 2013
National Cancer Institute (2012) Head and neck cancer: treatment. http://www.cancer.gov/cancertopics/treatment/head-and-neck. Accessed 4 Nov 2013
Deng J, Ridner S, Dietrich M, Wells N, Wallston K, Sinard R, Cmelak A, Murphy B (2012) Prevalence of secondary lymphedema in patients with head and neck cancer. J Pain Symptom Manag 42(2):244–252. doi:10.1016/j.jpainsymman.2011.03.019
Fingeret M, Vidrine D, Reece G, Gillenwater A, Gritz E (2010) Multidimensional analysis of body image concerns among newly diagnosed patients with oral cavity cancer. Head Neck 32:301–309. doi:10.1002/hed.21181
Buchman L, Conlee J, Hunt J, Agarwal J, White S (2013) Psychosocial distress is prevalent in head and neck cancer patients. Laryngoscope 123(6):1424–1429. doi:10.1002/lary.23886
Neilson K, Pollard A, Boonzaier A, Corry J, Castle D, Smith D, Trauer T, Couper J (2013) A longitudinal study of distress (depression and anxiety) up to 18 months after radiotherapy for head and neck cancer. Psycho-Oncol 22(8):1843–1848. doi:10.1002/pon.3228
Gil F, Costa G, Hilker I, Benito L (2012) First anxiety, afterwards depression: psychological distress in cancer patients at diagnosis and after medical treatment. Stress Health 28(5):362–367. doi:10.1002/smi.2445
Cash T, Fleming E (2002) The impact of body image experiences: development of the body image quality of life inventory. Int J Eat Disord 31:455–460. doi:10.1002/eat.10033
Radloff L (1977) The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1(3):385–401. doi:10.1177/014662167700100306
Fingeret M, Yuan Y, Urbauer D, Weston J, Mipomnick S, Weber R (2011) The nature and extent of body image concerns among surgically treated patients with head and neck cancer. Psycho-Oncol 21:836–844. doi:10.1002/pon.1990
Hagedoorn M, Molleman E (2006) Facial disfigurement in patients with head and neck cancer: the role of social self-efficacy. Health Psychol 25(5):643–647. doi:10.1037/0278-6133.25.5.643
American Cancer Society (2012) Cancer facts & figures 2012. American Cancer Society, Atlanta
Katre C, Johnson I, Humphris G, Lowe D, Rogers S (2008) Assessment of problems with appearance following surgery for oral and oro-pharyngeal cancer using the University of Washington appearance domain and the Derriford appearance scale. Oral Oncol 44:927–934. doi:10.1016/j.oraloncology.2007.12.006
Katz M, Irish J, Devins G, Rodin G, Gullane P (2003) Psychosocial adjustment in head and neck cancer: the impact of disfigurement, gender, and social support. Head Neck 25:103–112. doi:10.1002/hed.10174
Liu H (2008) Changes of satisfaction with appearance and working status for head and neck tumour patients. J Clin Nurs 17:1930–1938. doi:10.1111/j.1365-2702.2008.02291.x
Yang H, Wang L, Chang J, Fang F (2013) The health-related quality of life and bio-psycho-social adaptation effects in patients with head and neck cancer: a longitudinal study. Hu li za zhi J Nurs 60(5):41–52. doi:10.6224/JN.60.5.41
Acknowledgments
This research was supported by the National Institutes of Health 1R01CA149113-01A1, American Cancer Society DSCN-12-202-01-SCN, and National Center for Research Resources 1UL 1RR024975. The authors thank Dr. Jill Gilbert for assisting with study recruitment. The authors also acknowledge Dr. Thomas Cash who created the Body Image Quality of Life Inventory.
Conflict of interest
The authors have no conflicts of interest to declare.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Rhoten, B.A., Deng, J., Dietrich, M.S. et al. Body image and depressive symptoms in patients with head and neck cancer: an important relationship. Support Care Cancer 22, 3053–3060 (2014). https://doi.org/10.1007/s00520-014-2312-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00520-014-2312-2