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

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: 4.