Emotional and psychopathological disorders in laryngectomized oncological patients

It is unknown if patients who suffer from laryngeal cancer and undergo total laryngectomy experience as much emotional shock and psychological distress as patients with cancers in other locations do. The aim of the study was to identify the incidence of emotional and psychological disorders in laryngectomized patients and describe their symptomatological nuances.

A descriptive cross-sectional study of emotional and psychopathological response of 100 cancer patients undergoing total laryngectomy was performed. The patients were evaluated immediately after surgery (n=35), when initiating communicative rehabilitation (n=23) and 5 years after diagnosis (n=42), versus a control of 55 healthy subjects. Psychopathological assessment battery for anxiety, depression, intrusion, avoidance, arousal and posttraumatic stress disorder consisted of a specific interview, the Hospital Anxiety and Depression Scale (HADS) and the Impact of Event Scale-Revised (IES-R).

Laryngectomized patients had low incidence of emotional and psychological disorders such as anxiety (6.9%), depression (5.9%) and/or posttraumatic stress disorder (28.4%), but with sufficient intensity to constitute a psychopathological diagnosis. A significant level of distress was found in 57.4% of patients, with clear diffuse traumatic nature in 52.6% of them, which was more prevalent and intense in the rehabilitation group.

Symptoms of anxiety, depression and posttraumatic stress disorder during different stages after total laryngectomy are not of sufficient intensity and quality to be diagnosable clinical entities; they can be considered an adaptive disorder. The symptoms are less than those of patients with cancer in other locations and appear mostly in the rehabilitation stage, where preventive performances and psychological support should be focused.