Quality of Life and Psychiatric Morbidity in Patients Successfully Treated for Oral Cavity Squamous Cell Cancer and Their Wives

Zwahlen, Roger A.; Dannemann, Christine; Grätz, Klaus W.; Studer, Gabriela; Zwahlen, Diana; Moergeli, Hanspeter; Drabe, Natalie; Büchi, Stefan; Jenewein, Josef

doi:10.1016/j.joms.2007.09.003

« Previous Next »Journal of Oral and Maxillofacial Surgery
Volume 66, Issue 6 , Pages 1125-1132, June 2008

Quality of Life and Psychiatric Morbidity in Patients Successfully Treated for Oral Cavity Squamous Cell Cancer and Their Wives

Roger A. Zwahlen, MD, DMD
- Formerly, Consultant, Department of Cranio-Maxillofacial and Oral Surgery; and Currently, Clinical Associate Professor, Oral and Maxillofacial Surgery, The University of Hong Kong, Prince Philip Dental Hospital, Hong Kong.
- Address correspondence and reprint requests to Dr Zwahlen: Oral and Maxillofacial Surgery, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong
Christine Dannemann, MD
- Resident, Department of Cranio-Maxillofacial and Oral Surgery, University Hospital, Zurich, Switzerland.
Klaus W. Grätz, MD, DMD
- Professor and Chair, Department of Cranio-Maxillofacial and Oral Surgery, University Hospital, Zurich, Switzerland.
Gabriela Studer, MD
- Associate Professor, Department of Radiology, Division of Radiation Oncology, University Hospital, Zurich, Switzerland.
Diana Zwahlen, MA
- Clinical Psychologist, Outpatient Clinic for Psychiatry, University Hospital, Zurich, Switzerland.
Hanspeter Moergeli, PhD
- Clinical Psychologist and Statistician, Outpatient Clinic for Psychiatry, University Hospital, Zurich, Switzerland.
Natalie Drabe, MD
- Formerly, Resident, Outpatient Clinic for Psychiatry; and Currently, Consultant, Health and Psychology, Children's Hospital, Zurich, Switzerland.
Stefan Büchi, MD
- Associate Professor, Outpatient Clinic for Psychiatry, University Hospital, Zurich, Switzerland.
Josef Jenewein, MD
- Consultant, Outpatient Clinic for Psychiatry, University Hospital, Zurich, Switzerland.

Purpose

To assess quality of life (QOL) and psychiatric morbidity in successfully treated oral cavity squamous cell cancer (OC-SCC) survivors and their wives.

Patients and Methods

Thirty-one men successfully treated for OC-SCC (mean, 3.7 years since diagnosis; UICC stages I to IV) together with their wives were assessed by questionnaires referring to QOL (WHOQOL-BREF), physical complaints (EORTC QOL-H&N35), and symptoms of anxiety and depression (HADS). Prevalence of psychiatric disorders was assessed by the Mini International Neuropsychiatric Interview (M.I.N.I.).

Results

Irrespective of tumor stage, a considerably high global QOL both in OC-SCC survivors and their wives could be detected when compared with an age-matched cancer-free population. No significant difference between the mean scores of 4 domains of the QOL (exception: environmental domain) was found between patients and their wives. In patients, lower QOL was associated with more physical complaints (social eating, swallowing, and pain) and higher levels of psychological distress (HADS); whereas in wives, QOL was found to be related to levels of psychological distress. In the M.I.N.I., a high prevalence of psychiatric disorders, particularly anxiety disorders, was found in wives (38.7%); but was lower in patients (16.2%). Patients and wives diagnosed with a psychiatric disorder reported significantly lower QOL.

Conclusion

Both in OC-SCC patients and their wives a considerably high overall QOL can be found. “Social eating,” “swallowing,” and “sexuality” in patients and psychiatric disorders in wives seem to be strongly related to global QOL. The high prevalence of anxiety disorders in wives, however, should alert clinicians and the health care community. Thus, surgical improvement of somatic problems and treatment of psychiatric disorders should be addressed in individuals reporting an impaired global QOL.