Table 2. Mental Health (MH) and Substance Use Disorder (SUD) Characteristics of Survivors of Head and Neck Cancer (HNC) Before and After Diagnosis With and Without Suicidal Self-directed Violence (SSDV) Events.
| MH And SUD diagnoses and treatment encounters | No. (%) | |||||
|---|---|---|---|---|---|---|
| Total cohort (n = 7803) | Without SSDV (n = 7731) | With SSDV (n = 72) | ||||
| Before HNC diagnosis | After HNC diagnosis | Before HNC diagnosis | After HNC diagnosis | Before HNC diagnosis | After HNC diagnosis | |
| MH and SUD diagnosesa | ||||||
| PTSD | 926 (11.9) | 1072 (13.7) | 910 (11.8) | 1053 (13.6) | 16 (22.2) | 19 (26.4) |
| Anxiety disorder | 620 (8.0) | 1055 (13.5) | 608 (7.9) | 1028 (13.3) | 12 (16.7) | 27 (37.5) |
| Mood disorder | 1560 (20.0) | 2046 (26.2) | 1530 (19.8) | 1995 (25.8) | 30 (41.7) | 51 (70.8) |
| Any MH diagnosis | 1391 (17.8) | 1907 (24.4) | 1366 (17.7) | 1867 (24.1) | 25 (34.7) | 40 (55.6) |
| Nicotine SUD | 2355 (23.7) | 2445 (24.6) | 2326 (30.1) | 2412 (31.2) | 29 (40.3) | 33 (45.8) |
| Alcohol SUD | 1245 (12.5) | 1356 (13.6) | 1229 (15.9) | 1330 (17.2) | 16 (22.2) | 26 (36.1) |
| Cannabis SUD | 203 (2.0) | 258 (2.6) | 198 (2.6) | 244 (3.2) | 5 (6.9) | 14 (19.4) |
| Opioid SUD | 128 (1.3) | 129 (1.3) | 123 (1.6) | 115 (1.5) | 5 (6.9) | 14 (19.4) |
| Any SUD diagnosis | 2958 (37.9) | 3133 (40.2) | 2918 (37.7) | 3084 (40.0) | 40 (55.6) | 49 (68.0) |
| MH and SUD treatment use | ||||||
| Any MH visits | 2198 (28.2) | 3401 (43.6) | 2157 (27.9) | 3340 (43.2) | 41 (56.9) | 61 (84.7) |
| MH Treatment encounters,b median (IQR) | 4.0 (1-10) | 5.0 (1-12) | 4.0 (1-10) | 23.0 (4-62) | 13.0 (3-30) | 5.0 (1-11) |
| Time to first MH treatment encounter, mean (SD), d | NA | 210.1 (220.4) | NA | 208.7 (219.6) | NA | 233.0 (237.4) |
| Any SUD treatment visits | 399 (5.1) | 435 (5.6) | 388 (5.0) | 411 (5.3) | 11 (15.3) | 24 (33.3) |
| Time to first SUD treatment encounter, mean (SD), d | NA | 136.5 (167.2) | NA | 137.3 (167.4) | NA | 92.4 (151.4) |
| SUD Treatment encounters,b median (IQR) | 7.0 (2-34) | 4.0 (2-23) | 7.0 (4-34) | 4.0 (2-20) | 10.0 (5-94) | 16.5 (8-89) |
| Time to first palliative care encounter, mean (SD), d | NA | 151.0 (173.7) | NA | 149.2 (172.0) | NA | 275.6 (242.4) |
| Pain variables | ||||||
| Chronic pain | 1572 (19.6) | 2747 (35.2) | 1495 (19.3) | 2696 (34.9) | 32 (44.4) | 51 (70.1) |
| Prescription opioid MME,c mean (SD) (n = 6880) | 50.4 (96.7) | 88.8 (133.8) | 50.5 (97.3) | 77.9 (128.8) | 42.6 (35.4) | 121.6 (130.6) |
Abbreviations: MME, morphine milligram equivalent; NA, not applicable; PTSD, posttraumatic stress disorder.
a
Diagnoses are not mutually exclusive, so total percentage may exceed 100.
b
The MH and SUD treatment encounter medians and IQRs were calculated among those who had at least 1 encounter.
c
Total MME was only calculated for those who were currently prescribed opioids.