Increased risk of mental health problems after cancer during adolescence: A register‐based cohort study

Hovén, Emma; Ljung, Rickard; Ljungman, Gustaf; Ljungman, Lisa; Skoglund, Charlotte; Fransson, Emma; Wikman, Anna

doi:10.1002/ijc.33154

Cited by 7 publications

(19 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This study used a nationwide register‐based cohort design comparing the use of psychotropic medication in parents of adolescents diagnosed with cancer to parents of cancer‐free controls. The study procedures have been described in a previous publication on psychiatric morbidity among adolescents 21 …”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Psychotropic medication use in parents of survivors of adolescent cancer: A register‐based cohort study

et al. 2022

Self Cite

View full text Add to dashboard Cite

Background The aim was to investigate psychotropic medication use in parents of survivors of adolescent cancer from the acute post‐diagnostic phase and up to 2 years following the cancer diagnosis. Methods This study had a nationwide register‐based cohort design comparing psychotropic medication use in parents of adolescent survivors of cancer ( n = 2323) to use in parents of cancer‐free controls ( n = 20,868). Cox proportional hazards models, adjusted for cancer diagnostic group, parents' age, country of birth, education level, marital status and previous mental health problems estimated the risk of use from the time of the cancer diagnosis up to 2 years later. Results During the first 6 months after the cancer diagnosis, both mothers and fathers had an increased risk of use of anxiolytics (mothers: HR adj 1.71, 95% CI 1.30–2.25; fathers: HR adj 1.57, 95% CI 1.10–2.45) and hypnotics/sedatives (mothers: HR adj 1.53, 95% CI 1.23–1.90; fathers: HR adj 1.32, 95% CI 1.00–1.75). For fathers with a prescription of psychotropic medication during the first 6 months after the cancer diagnosis, the risk remained increased after 6 months (HR adj 1.66, 95% CI 1.04–2.65). From 6 months after the cancer diagnosis, only the risk of antidepressant use among mothers was increased (HR adj 1.38, 95% CI 1.08–1.76). Risk factors included being divorced/widowed, born in a non‐Nordic country, older age and having had previous mental health problems. Conclusion Our study results show that during the immediate post‐diagnostic phase, mothers and fathers of survivors of adolescent cancer are at increased risk of use of anxiolytics and sedatives, whereas only mothers are at increased risk of antidepressant use from 6 months until 2 years after the diagnosis. Further, previous mental health problems were shown to be the strongest risk factor for psychotropic medication use in both mothers and fathers, pointing to the particular vulnerability of these parents.

show abstract

Section: Methodsmentioning

confidence: 99%

“…The study procedures have been described in a previous publication on psychiatric morbidity among adolescents. 21 …”

Section: Methodsmentioning

confidence: 99%

Psychotropic medication use in parents of survivors of adolescent cancer: A register‐based cohort study

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…All adolescents ( n = 2822) who were born in Sweden from 1980 to 2003, registered as residents in Sweden at age 12, and had received a first cancer diagnosis in adolescence (13–19 years) were identified via the Swedish Cancer Register, 23 with an overall completeness of at least 96%. 29 The selection of participants born 1980 until 1993 was made based on the completeness and availability of data in the national registries.…”

Section: Methodsmentioning

confidence: 99%

“…This study is part of a larger research project on psychiatric consequences of adolescent cancer 23,24 . A diagnosis of cancer in adolescence occurs at a phase of physical, cognitive, psychological, and social development.…”

Section: Introductionmentioning

confidence: 99%

“…This study is part of a larger research project on psychiatric consequences of adolescent cancer. 23 , 24 A diagnosis of cancer in adolescence occurs at a phase of physical, cognitive, psychological, and social development. In addition to existing adolescent developmental challenges, adolescents with cancer and their parents are faced with specific cancer‐related stressors, including restrictions in activity, isolation from healthy peers, increased dependency on parents, and changes in physical appearance.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Losing a child to adolescent cancer: A register‐based cohort study of psychotropic medication use in bereaved parents

et al. 2022

Self Cite

View full text Add to dashboard Cite

Purpose: To investigate the short-and long-term risk of psychotropic medication use in parents who lose a child to cancer diagnosed in adolescence.Methods: This is a Swedish nationwide register-based study including 184 bereaved mothers and 184 bereaved fathers of 184 children diagnosed with cancer in adolescence. Logistic regression analyses, adjusted for sociodemographic characteristics and history of mental health problems, were performed to estimate risk of a prescription of psychotropic medication (anxiolytics, hypnotics/sedatives, antidepressants) in cancer-bereaved parents from 1 year before to 5 years after the child's death, with a general population sample of non-bereaved parents (n = 3291) as referents.Results: At the year of the child's death, 28%-36% of mothers and 11%-20% of fathers had a prescription of anxiolytics, hypnotics/sedatives or antidepressants.The corresponding percentages for non-bereaved mothers and fathers were 7%-12% and 4%-7%, respectively. Compared to non-bereaved mothers, bereaved mothers showed higher odds of prescriptions from 1 year before up to four (anxiolytics) and 5 years (hypnotics/sedatives and antidepressants) after the child's death. Bereaved fathers showed higher odds than non-bereaved fathers of prescriptions from 1 year before up to the year of (anxiolytics and hypnotics/sedatives) and 1 year after (antidepressants) the child's death. No differences in odds between bereaved and non-bereaved fathers were found at 2 years after the child's death. Being unmarried, born outside Sweden, and having a history of mental health problems were associated with higher odds of prescribed medications.Conclusions: Indicative of mental health problems of clinical importance, cancer-bereaved parents had a higher prevalence of use of psychotropic medication. A decrease in medication use was evident with time, but still at 5 years after the child's death mothers displayed a higher use while fathers showed no difference to non-bereaved fathers after 2 years.

show abstract

Lifetime Burden of Psychological Symptoms, Disorders, and Suicide Due to Cancer in Childhood, Adolescent, and Young Adult Years

et al. 2023

View full text Add to dashboard Cite

ImportanceA cancer diagnosis and treatment may result in highly traumatic periods with lasting psychological consequences for children, adolescent, and young adult patients with cancer (CYACs). Early identification and management may prevent long-term psychological morbidity and suicide.ObjectiveTo analyze risk, severity, and risk factors for depression, anxiety, psychotic disorders, and suicide in CYACs and noncancer comparators.Data SourcesLiterature search of PubMed, MEDLINE, Embase, PsycINFO, CINAHL, and PubMed Central from January 1, 2000, to November 18, 2022.Study SelectionFull-length articles in peer-reviewed journals that measured and reported risk and/or severity of depression, anxiety, psychotic disorders, and suicide mortality in CYACs and a noncancer comparator group.Data Extraction and SynthesisPreferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines were followed with prospective PROSPERO registration.Main Outcomes and MeasuresRisk ratios (RRs) were used for dichotomous outcomes, and standardized mean differences (SMDs) were used for continuous outcomes. SMDs were defined as follows: 0.2, small; 0.5, medium; and 0.8, large. Sources of heterogeneity and risk factors were investigated using sensitivity, subgroup, and meta-regression analyses.ResultsFrom 7319 records, 52 studies were included. Meta-analyses revealed that CYACs were at increased lifetime risk of severe symptoms or a disorder of depression (RR, 1.57; 95% CI, 1.29-1.92), anxiety (RR, 1.29; 95% CI, 1.14-1.47), and psychotic disorders (RR, 1.56; 95% CI, 1.36-1.80) relative to both matched controls and their siblings. Overall suicide mortality was not significantly elevated (RR, 1.63; 95% CI, 0.78-3.40). The mean severity of depression was found to be elevated in CYACs receiving treatment (SMD, 0.44; 95% CI, 0.13-0.74) and long-term survivors (SMD, 0.18; 95% CI, 0.02-0.33). The mean severity of anxiety was found to be elevated only during treatment (SMD, 0.16; 95% CI, 0.03-0.20).Conclusions and RelevanceFindings of this systematic review and meta-analysis suggest that CYACs may experience lasting psychological burden long into survivorship. Timely identification, preventive efforts, and psycho-oncological intervention for psychological comorbidity are recommended.

show abstract

Increased risk of mental health problems after cancer during adolescence: A register‐based cohort study

Cited by 7 publications

References 45 publications

Psychotropic medication use in parents of survivors of adolescent cancer: A register‐based cohort study

Psychotropic medication use in parents of survivors of adolescent cancer: A register‐based cohort study

Losing a child to adolescent cancer: A register‐based cohort study of psychotropic medication use in bereaved parents

Lifetime Burden of Psychological Symptoms, Disorders, and Suicide Due to Cancer in Childhood, Adolescent, and Young Adult Years

Contact Info

Product

Resources

About