목적: Emotional status of cancer patients are associated with disease course and treatment outcomes. This study aimed to evaluate the associations between pretreatment Beck Depression Inventory (BDI) scores and survival or nutritional outcomes in patients with head and neck squamous cell carcinoma (HNSCC). 방법:This study prospectively enrolled 243 patients with previously untreated HNSCC who underwent curative treatments. Patients were examined by self-administered BDI questionnaires. The pretreatment BDI was compared with EORTC QLQ scores. Univariate and multivariable analyses were performed to identify whether BDI scores are significantly associated with overall survival (OS), disease-free survival (DFS) and post-treatment nutritional change and post-treatment laboratory data. 결과:Two-year OS and DFS were 76.1% and 67.3% in patients with BDI scores >=10 and 84.0% and 83.3% in those with BDI <10. After controlling for clinical factors, BDI were significantly predictive of 2-year DFS (P = 0.010). BDI scores were significantly associated with all scores in EORTC QLQ-C30, and all items except feeding tube, nutritional supplement, problem mouth opening in EORTC QLQ-HN35 (P <0.05). At posttreatment 1 month, depressive patients showed lower body mass index and serum albumin level (P <0.05). 결론:This study provides evidence for significant relationship between pretreatment BDI scores and the survival or nutritional outcomes of HNSCC patients. Pretreatment evaluation and early intervention of depressive mood might improve survival and nutritional outcomes in HNSCC patients.