Gao XD, Ding Y, Li A, Chen X, Wang YJ. Psychological state and body image disturbance in head and neck cancer patients: Prevalence and determinants. World J Psychiatry 2026; 16(6): 114112 [DOI: 10.5498/wjp.v16.i6.114112]
Corresponding Author of This Article
Yu-Juan Wang, PhD, Department of Otolaryngology and Head and Neck Surgery, Shaanxi Provincial People’s Hospital, No. 256 Youyi West Road, Xi’an 710068, Shaanxi Province, China. wyujqz@126.com
Research Domain of This Article
Psychology
Article-Type of This Article
research-article
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Gao XD, Ding Y, Li A, Chen X, Wang YJ. Psychological state and body image disturbance in head and neck cancer patients: Prevalence and determinants. World J Psychiatry 2026; 16(6): 114112 [DOI: 10.5498/wjp.v16.i6.114112]
World J Psychiatry. Jun 19, 2026; 16(6): 114112 Published online Jun 19, 2026. doi: 10.5498/wjp.v16.i6.114112
Psychological state and body image disturbance in head and neck cancer patients: Prevalence and determinants
Xu-Dong Gao, Yu Ding, An Li, Xin Chen, Yu-Juan Wang
Xu-Dong Gao, Yu Ding, An Li, Yu-Juan Wang, Department of Otolaryngology and Head and Neck Surgery, Shaanxi Provincial People’s Hospital, Xi’an 710068, Shaanxi Province, China
Xin Chen, Breast Diagnosis and Treatment Center, Shaanxi Provincial People’s Hospital, Xi’an 710068, Shaanxi Province, China
Author contributions: Gao XD designed the research and wrote the first manuscript; Gao XD, Ding Y, Li A, and Chen X contributed to conceiving the research and analyzing data; Gao XD and Wang YJ conducted the analysis and provided guidance for the research; and all authors reviewed and approved the final manuscript.
Supported by the Shaanxi Provincial Natural Science Basic Research Program, No. 2023-JC-YB-769.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Shaanxi Provincial People’s Hospital.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: No additional data are available.
Corresponding author: Yu-Juan Wang, PhD, Department of Otolaryngology and Head and Neck Surgery, Shaanxi Provincial People’s Hospital, No. 256 Youyi West Road, Xi’an 710068, Shaanxi Province, China. wyujqz@126.com
Received: November 14, 2025 Revised: January 10, 2026 Accepted: March 3, 2026 Published online: June 19, 2026 Processing time: 195 Days and 1.2 Hours
Abstract
BACKGROUND
Head and neck cancer (HNC) usually imposes a psychological burden on patients. In particular, treatment-related facial changes often predispose them to body image disturbance (BID), thereby exacerbating psychological stress.
AIM
To characterize the psychological state (anxiety, depression) and BID status in patients with HNC and to identify determinants associated with BID.
METHODS
A total of 100 patients with HNC treated between January 2020 and January 2025 were analyzed. The psychological state was assessed using the Hospital Anxiety and Depression Scale-Anxiety (HADS-A) and Hospital Anxiety and Depression Scale-Depression (HADS-D) subscales, while body image-related distress was evaluated using the Body Image Scale (BIS). Linear associations among scales were examined using Pearson’s or Spearman’s correlation coefficients. Potential predictors of BID were evaluated using univariate and multivariable regression models.
RESULTS
Anxiety and depressive symptoms were identified in 25% and 30% of patients, respectively. Mean HADS-A and HADS-D scores were (5.62 ± 2.89) and 5.00 (3.00, 8.00), respectively, while the BIS total score was 16.00 (14.00, 18.00). Global BIS scores and all BIS domains (affective, cognitive, and behavioral) correlated positively with both HADS-A and HADS-D scores. Regression analyses identified multimodal treatment [odds ratio (OR) = 6.730, P = 0.011], female sex (OR = 5.206, P = 0.003), disease progression (OR = 4.316, P = 0.012), unemployment (OR = 3.461, P = 0.042), anxiety (HADS-A; OR = 4.031, P = 0.036), and depression (HADS-D; OR = 3.690, P = 0.039).
CONCLUSION
Patients with HNC commonly present with mild psychological issues accompanied by moderate BID. Female patients, those with late-stage cancer (III-IV), recipients of multimodal therapy, unemployed individuals, and patients with anxiety or depressive symptoms are at greater risk of BID.
Core Tip: This study assessed the psychological state and body image disturbance (BID) in patients with head and neck cancer and examined associated determinants. Among 100 head and neck cancer patients, mild psychological distress and moderate BID were observed. Female sex, stage III-IV disease, multimodal therapy, unemployment, and coexisting anxiety or depression were associated with a higher risk of BID, with female sex and multimodal therapy exerting the most significant effects.
