“…The level of mental distress among these patients corresponds with those found for other cancer locations. The determining risk factors for development of psychiatric morbidity among head and neck cancer patients have been suggested to include tumour stage, performance status, lack of social support and low social functioning, co-morbidity, previous psychiatric disease, pain and malnutrition (Shapiro and Kornfeld, 1987;Westin et al, 1988;Baile et al, 1992;Bjordal and Kaasa, 1995;McDonough et al, 1996;McQuellon and Hurt, 1997), but no single consistently strong risk factor has yet been found.…”