Mental disorders and psychosocial support during the first year after total laryngectomy: A prospective cohort study. (December 2013)

• Record Type: Journal Article
• Authors: Keszte, J.; Danker, H.; Dietz, A.; Meister, E.; Pabst, F.; Vogel, H.‐J.; Meyer, A.; Singer, S.
• Is Part Of: Clinical otolaryngology. Volume 38:Number 6(2013:Dec.)
• Page Start: 494
• Page End: 501
• Publication Date: 2013-12
• Subjects: Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1111/coa.12194
• Languages: English
• ISSNs: 1749-4478

Abstract

<abstract abstract-type="main" id="coa12194-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="coa12194-sec-0001" sec-type="section"> <title>Objectives</title> <p>To assess the frequency of mental disorders and the use of psychosocial services in laryngectomised patients during the first year after surgery.</p> </sec> <sec id="coa12194-sec-0002" sec-type="section"> <title>Design</title> <p>Multicentre prospective study including six interviews. Data regarding psychiatric comorbidity 3 months (3 m) and 1 year (12 m) after total laryngectomy (TLE) are reported in this study.</p> </sec> <sec id="coa12194-sec-0003" sec-type="section"> <title>Setting</title> <p>Structured interviews were conducted at nine hospitals and three rehabilitation centres in Germany.</p> </sec> <sec id="coa12194-sec-0004" sec-type="section"> <title>Participants</title> <p>One hundred and seventy‐one patients were interviewed at both time‐points.</p> </sec> <sec id="coa12194-sec-0005" sec-type="section"> <title>Main outcome measures</title> <p>Structured clinical interview for DSM‐IV (SCID).</p> </sec> <sec id="coa12194-sec-0006" sec-type="section"> <title>Results</title> <p>Mental disorders were diagnosed in 25% of the patients (3 m) and in 22% of the patients (12 m), respectively. Six per cent of the patients developed a mental disorder during the first year after total laryngectomy. In general, male and female patients suffered from mental disorders with equal frequency (3 m: 23% <italic>versus</italic> 37%; <italic>P</italic> = 0.26; 12 m: 22% <italic>versus</italic> 21%; <italic>P</italic> = 1.00). Women suffered more often than men from post‐traumatic stress disorder (3 m) (<italic>P </italic>= 0.01) and generalised anxiety disorder (12 m) (<italic>P</italic> = 0.01). Of the patients who had acquired no voice, 80% suffered from alcohol dependence (<italic>P</italic> = 0.01). There were no differences between men and women in receiving any kind of counselling (<italic>P</italic> = 0.79) or psychotherapy/psychiatric treatment (<italic>P</italic> = 0.47). Of those patients diagnosed with any mental disorder 3 months after total laryngectomy, 7% had received psychotherapy 1 year after total laryngectomy. None of the patients diagnosed with alcohol dependence received psychotherapy or psychiatric treatment.</p> </sec> <sec id="coa12194-sec-0007" sec-type="section"> <title>Conclusions</title> <p>Mental disorders occur in laryngectomees as frequently in men as they do in women. Total laryngectomised patients who were mentally ill did not receive enough psychotherapeutic or psychiatric support. As mental health seems to be related to successful voice restoration, future research should develop and evaluate special psychosocial supportive programmes for patients with laryngeal cancer, especially regarding alcohol dependence treatment.</p> </sec> </abstract>