Association between depression and survival or disease recurrence in patients with head and neck cancer enrolled in a depression prevention trial

Background. To determine if depression portends a worse prognosis in patients with head and neck cancer, we conducted a retrospective chart analysis of subjects who participated in a randomized placebo-controlled trial of citalopram for the prevention of depression during head and neck cancer treatment. Thirty-five patients were randomized, 34 with 1 or more evaluations form the basis of this report. Methods. We used the Hamilton Depression Rating Scale (HDRS), with a minimum follow-up of 24 months if no evidence of disease, or until recurrence or death from disease. Results. Fourteen of 34 subjects were depressed at any time during the 16 week RCT (HAMD >15). Seven of the 14 subjects in the depressed group were dead from disease or had recurrence, compared to 4 of 20 who never developed depression (p = .03). Stage of disease was equivalent in the 2 groups. Conclusion. This study suggests that depression in patients with head and neck cancer reduces survival.