Effect of Recognition of Head and Neck Malignancies on Patients' Psychosomatic Condition and Personality

Abstract

In order to elucidate the effect of recognition of head and neck malignancies on patients' psychosomatic condition and personality, we applied the Cornell Medical Index Health Questionnaire (CMI) and the Maudsley Personality Inventory (MPI) and collected medical and psychological data from 35 male (42-78 years of age; average 62. 5) and 15 female (20-76 years of age; average 54. 7) patients with malignant head and neck tumors (10 nose and paranasal, 8 oral, 8 pharyngeal, 14 laryngeal, 6 thyroid gland and 4 others). The two tests were done twice for each patients; at first immediately before hospitalization for treatment of the tumors at Mie University Hospital and secondly just before discharge from the hospital. The period of hospitalization ranged 1 to 13 months, average 3. 3 months. At the end of hospitalization doctors and nurses who had mainly taken care of the patients estimated the patients' recognition of their malignancy by analyzing behavior and information mainly from their family and classified patients into three groups; Group R (Patients who recognized that they were patients with head and neck malignancies) comprised 22 patients, Group N (who did not recognize the condition) comprised 15 and Group U (who could not be classified into Groups R or N) comprised 13. Comparison among the three groups revealed the followings. 1) Patients in Group R were relatively young (average 56. 3 years) and extrovert (estimated by MPI) and their somatic and psychological complaints registered on the CMI were less than those in other 2 groups. Psychosomatic condition after recognition that they had been patients with malignant tumors was better than before. That means the recognition did not badly affect at all. 2) The other two groups did not provide any estimate of the effect of malignancy-recognition by patients. Patients in Group U were considerably neurotic at admission and they were more depressive and autonomic nerve dysfunctioning at discharge. It might indicate that the psychosomatic condition in those patients became worse when they recognized the malignancy. Patients in Group N, older (average 65. 3 years) and mainly treated nonsurgically, were in good psychosomatic condition before and after the treatment. The effect of malignancy-recognition was quite obscure in this group. © 1991, The Oto-Rhino-Laryngological Society of Japan, Inc. All rights reserved.