{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:22:27Z","timestamp":1792174947235,"version":"4.4.0"},"reference-count":104,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2024,5,3]],"date-time":"2024-05-03T00:00:00Z","timestamp":1714694400000},"content-version":"vor","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,4,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with head and neck cancer present particularly considerable levels of emotional distress. However, the actual rates of clinically relevant mental health symptoms and disorders among this population remain unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A Preferred Reporting Items for Systematic Review and Meta-Analyses and Meta-analyses of Observational Studies in Epidemiology\u2013compliant systematic review and quantitative random-effects meta-analysis was performed to determine suicide incidence and the prevalence of depression, anxiety, distress, posttraumatic stress, and insomnia in this population. MEDLINE, Web of Science, Cochrane Central Register, KCI Korean Journal database, SciELO, Russian Science Citation Index, and Ovid-PsycINFO databases were searched from database inception to August 1, 2023 (PROSPERO: CRD42023441432). Subgroup analyses and meta-regressions were performed to investigate the effect of clinical, therapeutical, and methodological factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 208 studies (n\u2009=\u2009654\u200a413; median age = 60.7 years; 25.5% women) were identified. Among the patients, 19.5% reported depressive symptoms (95% confidence interval [CI] = 17% to 21%), 17.8% anxiety symptoms (95% CI\u2009=\u200914% to 21%), 34.3% distress (95% CI\u2009=\u200929% to 39%), 17.7% posttraumatic symptoms (95% CI\u2009=\u20096% to 41%), and 43.8% insomnia symptoms (95% CI\u2009=\u200935% to 52%). Diagnostic criteria assessments revealed lower prevalence of disorders: 10.3% depression (95% CI\u2009=\u20097% to 13%), 5.6% anxiety (95% CI\u2009=\u20092% to 10%), 9.6% insomnia (95% CI\u2009=\u20091% to 40%), and 1% posttraumatic stress (95% CI\u2009=\u20090% to 84.5%). Suicide pooled incidence was 161.16 per 100\u200a000 individuals per year (95% CI\u2009=\u200982 to 239). Meta-regressions found a statistically significant higher prevalence of anxiety in patients undergoing primary chemoradiation compared with surgery and increased distress in smokers and advanced tumor staging. European samples exhibited lower prevalence of distress.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with head and neck cancer presented notable prevalence of mental health concerns in all domains. Suicide remains a highly relevant concern. The prevalence of criteria-meeting disorders is significantly lower than clinically relevant symptoms. Investigating the effectiveness of targeted assessments for disorders in highly symptomatic patients is essential.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jncics\/pkae031","type":"journal-article","created":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T16:04:37Z","timestamp":1714579477000},"source":"Crossref","is-referenced-by-count":65,"title":["A comprehensive examination of mental health in patients with head and neck cancer: systematic review and meta-analysis"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7695-675X","authenticated-orcid":false,"given":"Pablo","family":"Jimenez-Labaig","sequence":"first","affiliation":[{"name":"Head and Neck Unit, The Royal Marsden NHS Foundation Trust , London, UK"},{"name":"The Institute of Cancer Research, National Institute of Health Research Biomedical Research Centre , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0040-1608","authenticated-orcid":false,"given":"Claudia","family":"Aymerich","sequence":"additional","affiliation":[{"name":"Psychiatry Department, Basurto University Hospital. Osakidetza, Basque Health Service , Bilbao, Spain"},{"name":"Biobizkaia Health Research Institute, OSI Bilbao-Basurto , Bilbao, Spain"},{"name":"Centro de Investigaci\u00f3n en Red de Salud Mental (CIBERSAM) , Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1068-9601","authenticated-orcid":false,"given":"Irene","family":"Bra\u00f1a","sequence":"additional","affiliation":[{"name":"Lung and Head & Neck Tumors Unit. Medical Oncology Department, Vall d\u2018Hebron University Hospital , Barcelona, Spain"},{"name":"Vall d\u2019Hebron Institute of Oncology (VHIO) , Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7365-9629","authenticated-orcid":false,"given":"Antonio","family":"Rullan","sequence":"additional","affiliation":[{"name":"Head and Neck Unit, The Royal Marsden NHS Foundation Trust , London, UK"},{"name":"The Institute of Cancer Research, National Institute of Health Research Biomedical Research Centre , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6195-8034","authenticated-orcid":false,"given":"Jon","family":"Cacicedo","sequence":"additional","affiliation":[{"name":"Radiotherapy Department, Cruces University Hospital , Barakaldo, Spain"},{"name":"Biobizkaia Health Research Institute, OSI Ezkerraldea Enkarterri Cruces , Barakaldo, Spain"},{"name":"Faculty of Medicine, University of the Basque Country , Leioa, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4017-2785","authenticated-orcid":false,"given":"Miguel \u00c1ngel","family":"Gonz\u00e1lez-Torres","sequence":"additional","affiliation":[{"name":"Psychiatry Department, Basurto University Hospital. Osakidetza, Basque Health Service , Bilbao, Spain"},{"name":"Biobizkaia Health Research Institute, OSI Bilbao-Basurto , Bilbao, Spain"},{"name":"Centro de Investigaci\u00f3n en Red de Salud Mental (CIBERSAM) , Madrid, Spain"},{"name":"Neuroscience Department, University of the Basque Country (UPV\/EHU) , Leioa, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6014-348X","authenticated-orcid":false,"given":"Kevin J","family":"Harrington","sequence":"additional","affiliation":[{"name":"Head and Neck Unit, The Royal Marsden NHS Foundation Trust , London, UK"},{"name":"The Institute of Cancer Research, National Institute of Health Research Biomedical Research Centre , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Catalan","sequence":"additional","affiliation":[{"name":"Psychiatry Department, Basurto University Hospital. 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