{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T17:08:46Z","timestamp":1785431326786,"version":"3.56.0"},"reference-count":31,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Victor Babes University of Medicine and Pharmacy Timisoara"},{"id":[{"id":"https:\/\/ror.org\/00afdp487","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Alcohol misuse, depressive symptoms, maladaptive coping, and impaired health-related quality of life (HRQoL) are clinically relevant in head-and-neck cancer, but their interrelationships are not fully captured by clinical stage alone. This multicenter study examined these domains at first admission and explored whether data-driven psychosocial phenotypes could complement stage-based stratification. Materials and Methods: In this multicenter cross-sectional study conducted at participating ENT\/oncology centers in Timi\u0219oara and Oradea, Romania, during May 2024\u2013October 2026, 64 adults with head-and-neck cancer completed the Alcohol Use Disorders Identification Test (AUDIT), Patient Health Questionnaire-9 (PHQ-9), EuroQol five-dimension questionnaire (EQ-5D), and Coping Orientation to Problems Experienced (COPE). Patients were compared by stage (I\u2013III vs. IV). We also examined correlations, modeled poor HRQoL (EQ-5D health sum \u2264 9), derived COPE factor scores, identified psychosocial profiles by unsupervised clustering, and explored an indirect-association framework linking AUDIT, PHQ-9, and EQ-5D problem severity. Results: Stage IV disease was associated with greater tumor burden but not with worse psychosocial scores. Overall, 18.8% met criteria for possible alcohol dependence (AUDIT \u2265 20), and PHQ-9 scores correlated with poorer EQ-5D health status (\u03c1 = \u22120.275; p = 0.028). Three psychosocial profiles showed significant differences in alcohol-risk burden, depressive symptoms, and coping signatures. The exploratory indirect-effect analysis did not support a statistically significant PHQ-9-mediated association between AUDIT and EQ-5D problem severity (indirect effect 0.002; 95% CI \u22120.018 to 0.022). Conclusions: Alcohol-related risk and depression-associated HRQoL burden were common and were not meaningfully explained by stage alone. Exploratory phenotype-based stratification may help identify patients who could benefit from earlier supportive-care triage.<\/jats:p>","DOI":"10.3390\/medicina62040671","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T15:14:43Z","timestamp":1775142883000},"page":"671","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Alcohol-Related Risk, Depressive Symptoms, HRQoL, and Coping Phenotypes in Head-and-Neck Cancer: A Multicenter Cross-Sectional Study Stratified by Clinical Stage"],"prefix":"10.3390","volume":"62","author":[{"given":"Alexandru-Romulus","family":"Hut","sequence":"first","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3690-8048","authenticated-orcid":false,"given":"Gheorghe","family":"Iovanescu","sequence":"additional","affiliation":[{"name":"Department of Ear-Nose-Throat, Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugen Radu","family":"Boia","sequence":"additional","affiliation":[{"name":"Department of Ear-Nose-Throat, Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7210-1263","authenticated-orcid":false,"given":"Delia Ioana","family":"Horhat","sequence":"additional","affiliation":[{"name":"Department of Ear-Nose-Throat, Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrada Ioana","family":"Dumitru","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphael","family":"Galant","sequence":"additional","affiliation":[{"name":"Lariboisiere University Hospital, University Paris Cit\u00e9, Assistance Publique des H\u00f4pitaux de Paris (AP-HP), 75015 Paris, France"},{"name":"U1123, National Institute of Health and Medical Research, University Paris Cit\u00e9, 75006 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cosmin","family":"Rosca","sequence":"additional","affiliation":[{"name":"Oculens Clinic, Calea Turzii, No. 134-136, 400501 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4581-8487","authenticated-orcid":false,"given":"Andreea Mihaela","family":"Kis","sequence":"additional","affiliation":[{"name":"Department of Management and Communication in Dental Medicine, Department I, Faculty of Dental Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7755-4608","authenticated-orcid":false,"given":"Nicolae Constantin","family":"Balica","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"key":"ref_1","first-page":"229","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J. 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