Hostname: page-component-6766d58669-76mfw Total loading time: 0 Render date: 2026-05-18T08:45:15.550Z Has data issue: false hasContentIssue false
  • English
  • Français

Insomnia, depression and anxiety in patients urgently referred with suspicion of head and neck cancer

Published online by Cambridge University Press:  22 May 2023

Thomas Mullan Open the ORCID record for Thomas Mullan [Opens in a new window] ,
Jenny Montgomery Open the ORCID record for Jenny Montgomery [Opens in a new window]  and
Leanne Fleming
Thomas Mullan*
Affiliation:
Glasgow University Medical School, Glasgow, Scotland, UK
Jenny Montgomery
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
Leanne Fleming
Affiliation:
School of Psychological Sciences and Health, Strathclyde University, Glasgow, Scotland, UK
*
Corresponding author: Thomas Mullan; Email: thomasmullan@btinternet.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

To determine differences in insomnia, depression and anxiety between ENT patients with benign and malignant conditions prior to and after an urgent suspicion of cancer appointment.

Methods

Out-patients with urgent suspicion of cancer completed three psychometric questionnaires prior to their appointment and at two to four weeks post-diagnosis.

Results

There was no significant difference in questionnaire scores between malignant and benign patients prior to the patients’ appointments (p > 0.05 for all questionnaires). In benign patients, there was significant improvement in scores for all questionnaires (p < 0.01) and in malignant patients there was significant worsening of scores for all questionnaires (p < 0.01) at follow-up appointments.

Conclusion

Prior to appointments, patients with benign and malignant conditions experienced similar levels of insomnia, depression and anxiety. Following diagnosis, cancer patients had significantly poorer scores, indicating worsening of these symptoms. In patients with benign diagnoses, all questionnaire scores improved, indicating resolution of their symptoms and possible association between the appointment and their baseline scores.

Keywords

Diagnosishealth planning guidelinesoral pathologypsychologysleep

Information

Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 138 , Issue 3 , March 2024 , pp. 325 - 330
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

Footnotes

Thomas Mullan takes responsibility for the integrity of the content of the paper

Presented at the ENT Scotland Winter Meeting, 3 December 2021, Stirling, Scotland, UK.

References

Scottish Referral Guidelines for Suspected Cancer. In: https://www.gov.scot/binaries/content/documents/govscot/publications/advice-and-guidance/2019/01/scottish-referral-guidelines-suspected-cancer-january-2019/documents/scottish-referral-guidelines-suspected-cancer/scottish-referral-guidelines-suspected-cancer/govscot%3Adocument/scottish-referral-guidelines-suspected-cancer.pdf [22 January 2019]Google Scholar
McKie, C, Ahmad, UA, Fellows, S, Meikle, D, Stafford, FW, Thomson, PJ et al. The 2-week rule for suspected head and neck cancer in the United Kingdom: referral patterns, diagnostic efficacy of the guidelines and compliance. Oral Oncol 2007;44:851–6CrossRefGoogle Scholar
Lyons, M, Philpott, J, Hore, I, Watters, G. Audit of referrals for head and neck cancer – the effect of the 2-week, fast track referral system. Clin Otolaryngol Allied Sci 2004;29:143–5CrossRefGoogle ScholarPubMed
Lim, AE, Douglas, CM, Montgomery, J. An open structure questionnaire on reasons for delay in presentation: a study of patients attending clinic with red flag symptoms of head and neck cancer. Eur Arch Otorhinolaryngol 2020;277:1801–6CrossRefGoogle ScholarPubMed
Santoso, A, Jansen, F, de Vries, R, Leemans, CR, van Straten, A, Verdonck-de Leeuw, IM. Prevalence of sleep disturbances among head and neck cancer patients: a systematic review and meta-analysis. Sleep Med Rev 2019;47:62–73CrossRefGoogle ScholarPubMed
Li, L, Wu, C, Gan, Y, Qu, X, Lu, Z. Insomnia and the risk of depression: a meta-analysis of prospective cohort studies. BMC Psychiatry 2016;16:375CrossRefGoogle ScholarPubMed
Bragantini, D, Sivertsen, B, Gehrman, P, Lydersen, S, Güzey, IC. Differences in anxiety levels among symptoms of insomnia. The HUNT study. Sleep Health 2019;5:370–5CrossRefGoogle ScholarPubMed
Van Beek, FE, Jansen, F, Mak, L, Lissenberg-Witte, BI, Buter, J, Vergeer, MR et al. The course of symptoms of anxiety and depression from time of diagnosis up to 2 years follow-up in head and neck cancer patients treated with primary (chemo)radiation. Oral Oncol 2020;102:104576CrossRefGoogle ScholarPubMed
Sleep Related Questionnaires. Insomnia Severity Index (ISI). In: https://www.thoracic.org/members/assemblies/assemblies/srn/questionaires/isi.php [1 December 2016]Google Scholar
Bastien, CH, Vallières, A, Morin, CM. Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med 2001;2:297–307CrossRefGoogle ScholarPubMed
Kroenke, K, Spitzer, RL, Williams, JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001;16:606–13CrossRefGoogle ScholarPubMed
Rutter, LA, Brown, TA. Psychometric properties of the generalized anxiety disorder scale-7 (GAD-7) in outpatients with anxiety and mood disorders. J Psychopathol Behav Assess 2017;39:140–6CrossRefGoogle ScholarPubMed
Dhull, AK, Atri, R, Dhankhar, R, Chauhan, AK, Kaushal, V. Major risk factors in head and neck cancer: a retrospective analysis of 12-year experiences. World J Oncol 2018;9:80–4CrossRefGoogle ScholarPubMed
Santoso, A, Jansen, F, Lissenberg-Witte, BI, Baatenburg de Jong, RJ, Langendijk, JA, Leemans, CR et al. Poor sleep quality among newly diagnosed head and neck cancer patients: prevalence and associated factors. Support Care Cancer 2021;29:1035–45CrossRefGoogle ScholarPubMed
Langton, S, Siau, D, Bankhead, C. Two-week rule in head and neck cancer 2000–14: a systematic review. Br J Oral Maxillofac Surg 2016;54:120–31CrossRefGoogle ScholarPubMed
Cornford, CS, Harley, J, Oswald, N. The ‘2-week rule’ for suspected breast carcinoma: a qualitative study of the views of patients and professionals. Br J Gen Pract 2004;54:584–8Google ScholarPubMed
Ndukwe, N, Borowski, DW, Lee, A, Orr, A, Dexter-Smith, S, Agarwal, AK. The two-week rule for suspected colorectal cancer: patient experience and psychological impact. Int J Health Care Qual Assur 2012;25:75–85CrossRefGoogle ScholarPubMed
Wong, B, Fischer, S, Cruickshank, HE. Clinical outcome of head and neck cancer patients: a comparison between ENT patients referred via the 2 weeks wait pathway and alternative routes in the UK health system. Eur Arch Otorhinolaryngol 2017;274:415–20CrossRefGoogle ScholarPubMed
Roy, S, Anjum, K. The two-week wait – a qualitative analysis of suspected head and neck cancer referrals. Br Dent J 2018;225:159–63CrossRefGoogle Scholar
Tikka, T, Kavanagh, K, Lowit, A, Jiafeng, P, Burns, H, Nixon, IJ et al. Head and neck cancer risk calculator (HaNC-RC)-V.2. Adjustments and addition of symptoms and social history factors. Clin Otolaryngol 2020;45:380–8CrossRefGoogle ScholarPubMed