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Background <p>Oral cancer, primarily oral squamous cell carcinoma (OSCC), is a major malignancy in India, linked to significant depression due to treatment-related disfigurement, functional impairments, and socio-economic challenges. This study evaluates depression risks, recognition, and proposes recommended management strategies based on literature and clinical insights. A prospective longitudinal study enrolled 100 OSCC participants (aged ≥ 18 years) at tertiary care centers in Shimla, India, from March 2022 to January 2024, with follow-up at baseline, 2 weeks, 1 month, and 6 months post-treatment (<i>n</i> = 95 completed 6-month follow-up [5% attrition]). Depression was assessed using the Depression, Anxiety, and Stress Scale-21 (DASS-21). Quality of life (QoL) was measured with the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck Module (EORTC QLQ-H&amp;N43). Data were analyzed using SPSS version 19.0 with repeated measures ANOVA (<i>p</i> &lt; 0.05 significant). The cohort (<i>n</i> = 100) was predominantly male (88%), middle-aged (mean 55.0 ± 10.2 years), Hindu (98%), married (90%), and from low socio-economic backgrounds (56% unskilled laborers). Depression scores rose significantly (mean ± SD): baseline 2.8 ± 2.1, 2 weeks 5.9 ± 3.4, 1 month 9.3 ± 4.8, 6 months 15.0 ± 6.2 (95% CI: 13.8–16.2; <i>p</i> &lt; 0.001), progressing from normal to moderate depression. Risk factors included advanced stage (III/IV: 49%), combined modality treatment (82%), and substance abuse (<i>p</i> &lt; 0.001). EORTC scores showed worsening pain, swallowing, and speech, with a strong positive correlation with depression (<i>r</i> = 0.68), indicating poorer QoL with higher depression. Clinical recognition via structured DASS-21 reassessments improved post-counseling, but 40% of cases remained undetected. Depression escalates in Indian OSCC survivors, impacting QoL and treatment adherence. Routine DASS-21 screening and interventions like psychiatric counseling, psychoeducation, and support groups are recommended. Multicenter studies and scalable interventions are needed to address India’s cancer-related mental health burden.</p>

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Risks, Recognition, and Recommended Management Strategies for Depression in Oral Cancer Survivors in India: A Prospective Longitudinal Study

  • 期刊论文

  • 发表日期：

    2026年6月1日

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  • Abhijeet kamble,
  • Rangila Ram,
  • Manish Sahore,
  • Narotam Ghezta

摘要

Background

Oral cancer, primarily oral squamous cell carcinoma (OSCC), is a major malignancy in India, linked to significant depression due to treatment-related disfigurement, functional impairments, and socio-economic challenges. This study evaluates depression risks, recognition, and proposes recommended management strategies based on literature and clinical insights. A prospective longitudinal study enrolled 100 OSCC participants (aged ≥ 18 years) at tertiary care centers in Shimla, India, from March 2022 to January 2024, with follow-up at baseline, 2 weeks, 1 month, and 6 months post-treatment (n = 95 completed 6-month follow-up [5% attrition]). Depression was assessed using the Depression, Anxiety, and Stress Scale-21 (DASS-21). Quality of life (QoL) was measured with the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck Module (EORTC QLQ-H&N43). Data were analyzed using SPSS version 19.0 with repeated measures ANOVA (p < 0.05 significant). The cohort (n = 100) was predominantly male (88%), middle-aged (mean 55.0 ± 10.2 years), Hindu (98%), married (90%), and from low socio-economic backgrounds (56% unskilled laborers). Depression scores rose significantly (mean ± SD): baseline 2.8 ± 2.1, 2 weeks 5.9 ± 3.4, 1 month 9.3 ± 4.8, 6 months 15.0 ± 6.2 (95% CI: 13.8–16.2; p < 0.001), progressing from normal to moderate depression. Risk factors included advanced stage (III/IV: 49%), combined modality treatment (82%), and substance abuse (p < 0.001). EORTC scores showed worsening pain, swallowing, and speech, with a strong positive correlation with depression (r = 0.68), indicating poorer QoL with higher depression. Clinical recognition via structured DASS-21 reassessments improved post-counseling, but 40% of cases remained undetected. Depression escalates in Indian OSCC survivors, impacting QoL and treatment adherence. Routine DASS-21 screening and interventions like psychiatric counseling, psychoeducation, and support groups are recommended. Multicenter studies and scalable interventions are needed to address India’s cancer-related mental health burden.