Head and neck cancer is a debilitating disease with approximately 890,000 incident cases each year [1]. It is defined as cancer of the oral cavity, pharynx (nasopharynx, oropharynx, hypopharynx), larynx, nasal cavity, paranasal sinus, and/or salivary glands and treatment includes surgery, radiation, and chemotherapy [2,3]. Side effects of treatment are often visible and impair essential daily functions such as swallowing, breathing, eating and speech [2,3]. Moreover, HNC and its treatment have been associated with the experience of psychological distress and poor health-related quality of life (HRQOL) in many studies, including depression and anxiety [[4], [5], [6], [7]]. Previous studies have shown that many HNC patients report their lowest HRQOL around 3 months postdiagnosis due to treatment-related side effects, whereas by 12 months postdiagnosis, symptoms have improved and their HRQOL has stabilized at a level approximating pretreatment values [8,9]. This is not true of all patients, however, and it is therefore important to examine factors that may impair optimal recovery of function in the months following treatment when many patients would be expected to demonstrate improvements in important disease-specific HRQOL outcomes.

As several studies have indicated, depressive symptoms are common in patients with HNC and may complicate recovery [[4], [5], [6], [7]]. Depression may impact a host of important processes and survivorship outcomes including adherence to treatment, discontinuation of follow-up care, disease-specific HRQOL, and survival [4,[10], [11], [12], [13]], underscoring the need for screening and management of depression as advocated by the American Society of Clinical Oncology in their evidence-based clinical practice guidelines [14,15]. Better understanding of the prevalence and persistence of depressive symptoms in HNC, particularly during the initial 12 months postdiagnosis, is therefore warranted. The present descriptive study sought to (1) examine the prevalence of persistent mild and moderate-severe depressive symptomatology occurring for at least 6 months during the first year postdiagnosis in a large sample of HNC survivors (N = 946) and (2) describe the HNC-specific HRQOL of four a priori selected groups: (a) patients with persistently elevated moderate-severe depressive symptoms; (b) patients with persistently elevated mild depressive symptoms, (c) patients with transient (ie, lasting <6 months) depressive symptoms, and (d) patients not reporting elevated depressive symptoms during the first year postdiagnosis, termed resilient.