ORIGINAL ARTICLE Contextual and historical factors for increased levels of anxiety and depression in patients with head and neck cancer: A prospective longitudinal study Melissa Henry PhD 1,2,3,4,5 | Fabienne Fuehrmann MSc 1,2 | Michael Hier MD 2,3 | Anthony Zeitouni MD 3,6 | Karen Kost MD 3,6 | Keith Richardson MD 3,6 | Alex Mlynarek MD 3,4,6 | Martin Black MD 3,4 | Christina MacDonald RN, MSc(N) 7 | Gabrielle Chartier RN, MSc(N) 7 | Xun Zhang PhD 8 | Zeev Rosberger PhD 1,5,9 | Saul Frenkiel MD 3,4 1 Department of Oncology, McGill University, Montreal, Quebec, Canada 2 Department of Oncology, Jewish General Hospital, Montreal, Quebec, Canada 3 Department of Otolaryngology – Head and Neck Surgery, McGill University, Montreal, Quebec, Canada 4 Department of Otolaryngology – Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada 5 Lady-Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada 6 McGill University Health Centre, Montreal, Quebec, Canada 7 Department of Nursing, Jewish General Hospital, Montreal, Quebec, Canada 8 McGill University Health Centre Research Institute, Montreal, Quebec, Canada 9 Department of Psychology, McGill University, Montreal, Quebec, Canada Correspondence Melissa Henry, Faculty of Medicine, Department of Oncology, McGill University, FRQS Clinician-Scientist, Lady- Davis Institute for Medical Research, Jewish General Hospital, 3755 Côte Ste. Catherine Road, Pavilion E room E-872, Montreal, Quebec, H3T 1E2, Canada. Email: melissa.henry@mcgill.ca Abstract Background: This study aimed at examining predictors of clinical anxiety and depressive symptoms in patients with head and neck cancer (HNC) at 3, 6, and 12 months post-diagnosis, with a particular interest in contextual and historical factors. Methods: Prospective longitudinal study of 219 consecutive patients newly diag- nosed with a first occurrence of primary HNC, including psychometric measures, Structured Clinical Interview for DSM-IV Diagnoses (SCID), and medical chart reviews. Results: Point prevalence of clinical anxiety symptoms (Hospital Anxiety and Depression Scale-Anxiety subscale) was 32.0%, 21.9%, 12.1%, and 12.6% at base- line, 3, 6, and 12 months; and clinical depressive symptoms on the Depression Subscale was 19.4%, 21.9%, 13.5%, and 9.2%, respectively. Predictors of anxiety and depressive symptoms included upon diagnosis SCID major depressive or anxiety disorder, stressful life events in previous year, neuroticism, and levels of anxiety and depressive symptoms upon cancer diagnosis. Conclusions: This study emphasizes the predictive contribution of broader per- sonal contextual and historical factors that increase psychological vulnerability in HNC and merit consideration. KEYWORDS anxiety disorder, cancer, head and neck cancer, major depressive disorder, oncology, stressful life events 1 | BACKGROUND Head and neck cancer (HNC) is generally diagnosed in advanced stage (50% in stage III or IV), 1 and 5-year survival rates range from 28% to 67% 2 (Canadian Cancer Society's Advisory Committee on Cancer Statistics, 2017). Depending largely on medical presentation and quality of life consider- ations, treatment typically consists of a combined surgery, Received: 20 November 2017 Revised: 1 February 2019 Accepted: 18 February 2019 DOI: 10.1002/hed.25725 Head & Neck. 2019;1–11. wileyonlinelibrary.com/journal/hed © 2019 Wiley Periodicals, Inc. 1