Association between self-esteem and depression among patients with head and neck cancer: A pilot study

Background. We examined the psychological distress in patients with head and neck cancer and investigated how preoperative self-esteem influenced psychological distress during treatment. Methods. Fifty-eight patients who were scheduled for surgery for head and neck cancer participated. The Japanese version of hospital anxiety and depression scale (HADS) was administered preoperatively, after surgery, and 6 months post-operatively, and Rosenberg self-esteem scale was administered preoperatively and 6 months postoperatively. Results. There were significant differences among the 3 examination periods for psychological distress; the course of anxiety and depression differed between the high self-esteem group (HSEG) and the low self-esteem group (LSEG). In all examination periods, anxiety and depression scores for HSEG were significantly better than for LSEG. As for depression, scores did not change significantly over time in HSEG, whereas the scores went from bad to worse in LSEG. Conclusions. Patients with cancer undergoing surgery, especially patients with low self-esteem, need preoperative and ongoing intervention. (C) 2008 Wiley Periodicals, Inc.