Post-Traumatic Stress Symptoms in Head and Neck Cancer Patients: The Impact of the COVID-19 Pandemic and Gene-Environment Interaction.

Abstract

This study aimed to assess the occurrence of post-traumatic stress symptoms (PTSS) in head and neck cancer (HNC) patients. The goal also was to explore potential associations between PTSS, demographic factors, psychological variables, and specific genetic variants. This study included a total of 155 HNC patients, divided into pre-pandemic (n = 76) and COVID-19 pandemic (n = 79) groups. PTSS assessments were conducted using a standardized questionnaire. The assessment of adverse childhood experiences (ACEs) involved specific questionnaire items. Genetic variants were identified via RT-PCR. Statistical analysis employed linear multivariate regression, while mediation analysis examined gene-environment interactions. In the pre-pandemic, higher PTSS scores were found to be associated with younger age (p = 0.02) and a history of cumulative ACEs (p = 0.001). Mediation analysis revealed that ACEs had a direct impact on PTSS scores, with the FKBP5 CC genotype (rs1360780, C>T) mediating this association by 29%. In the pandemic, elevated PTSS scores were correlated with a history of depression (p = 0.001), the negative impact of the pandemic (p = 0.007), and undergoing palliative treatment (p = 0.02). Our findings provide insights into the psychosocial and genetic factors contributing to PTSS in HNC patients, considering the additional stressors introduced by the COVID-19 pandemic.