Abstract 1426P
Background
Head and neck cancer (HNC) diagnosis could trigger post-traumatic stress disorder (PTSD). In addition, adverse childhood experiences (ACEs), depression, and individual differences in cortisol levels could influence the vulnerability to PTSD in cancer patients. Single nucleotide variants (SNVs) on genes of the hypothalamic-pituitary-adrenal axis, involved in stress response, such as CRHR1 (rs110402, C/T), FKBP5 (rs3800373, G/T), and NR3C1 (rs41423247, C/G), may impact cortisol production. However, the influence of psychosocial and genetic factors on HNC-related PTSD is not fully known. This study aimed to evaluate the association between these vulnerability factors and HNC-related PTSD.
Methods
Eighty-five HNC patients were included in this study. The PTSD Checklist (Civilian Version) (PCL-C) instrument measured PTSD. The ACEs were collected by related questions about physical, sexual, and emotional abuse, and family issues. Beck Depression Inventory (BDI) measured depression information. The genomic DNA of all patients was analyzed by real-time PCR to identify the SNVs genotypes. The PCL-C and BDI cut-off points were 44 and 31, respectively. Differences between groups were assessed by Fisher’s exact test or chi-square, and logistic regression.
Results
Eighteen patients (21.2%) met the criteria for PTSD. Thirty-four of patients (40.0%) presented a least two ACEs. Eighteen patients (21.2%) met the criteria for severe depression. PTSD was most common in HNC patients with at least two ACEs (66.7% vs. 32.8%, p= 0.01), with severe depression at diagnosis (72.2% vs. 7.5%, p< 0.0001), and in who carried variant CRHR1 TT genotype (38.9% vs. 11.9%, p= 0.01), on the univariate analysis. After multivariate analysis, severe depression (OR: 37.8, 95% CI: 8.2-173.7, p< 0.0001) and CRHR1 TT (OR: 6.53, 95% CI: 1.22-34.87, p= 0.02) remained significant.
Conclusions
Severe depression and variant CRHR1 TT genotype seem to influence the PTSD in our sample. We believe that our results, once validated in a larger study, could contribute to identifying psychological and genetic aspects that may influence vulnerability to PTSD in HNC patients, which would benefit from psychological interventions.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.