Longitudinal patterns of psychological distress in adult survivors of childhood cancer

Abstract

Background:This study investigated longitudinal patterns of psychological distress in adult survivors of childhood cancer.Methods:Participants included 4569 adult survivors in the Childhood Cancer Survivor Study Cohort (CCSS) who completed the Brief Symptom Inventory-18 on three occasions between 1994 and 2010. Longitudinal latent class analysis was used to identify discrete classes of psychological distress. Predictors of class membership were examined through logistic regression modelling with odds ratios (ORs) and 95% confidence intervals (CIs) reported.Results:Survivors were a median of 39 years of age and 30 years from diagnosis at the most recent follow-up. Most survivors reported few or no symptoms of distress over time, although subsets of survivors reported persistently elevated (depression: 8.9% anxiety: 4.8% somatisation: 7.2%) or significant increases in distress symptoms over the follow-up period (depression: 10.2% anxiety: 11.8% somatisation: 13.0%). Increasing distress symptoms were predicted by survivor perception of worsening physical health over time (depression: OR=3.3; 95% CI=2.4–4.5; anxiety: OR=3.0; 95% CI=2.2–4.0; somatisation: OR=5.3; 95% CI=3.9–7.4). Persistent distress symptoms were also predicted by survivor perception of worsening physical health over time, as well as by worsening pain and ending analgesic use.Conclusion:Subgroups of adult survivors are at-risk for chronic distress or significant increases in distress decades following their original cancer diagnosis. Routine screening of psychological distress in adult survivors of childhood cancer is warranted, especially for survivors who experience physical health morbidities.

Neurocognitive outcomes in long-term survivors of childhood acute lymphoblastic leukemia treated on contemporary treatment protocols: A systematic review

“…There are a variety of factors that were not evaluated in this review, such as the influence of health status and lifestyle (metabolic syndromes, chronic conditions, nutritional status, symptoms management, physical activity and psychological well-being)(Badr et al,2013; Brinkman et al,2013; Hartman et al,2013; Huang et al,2013; Tonorezos et al,2013), environmental factors (coping strategies, education and psychological status of family members)(Norberg and Boman,2008; Trask et al,2009; Tremolada et al,2013; Long et al,2014; Williams et al,2014; Williams and McCarthy,2014 ) and the interaction between chemotherapy and other supportive care drugs that may exert additive neurotoxic effects (antibiotics, antifungals and neuropsychiatric drugs)(Haidar and Jeha,2011; van Schie et al,2011; Barrett et al,2013; Ruggiero et al,2013). A multidisciplinary approach is needed to ascertain the impact of contemporary ALL treatments on these adverse outcomes.…”

The unmet emotional, care/support, and informational needs of adult survivors of pediatric malignancies

“…Anxiety is more common among cancer survivors than among the general population [43]. Although most childhood cancer survivors have normal psychological functioning [44, 45, 46], distressed psychological states may give rise to multiple needs. Adult patients with cancer who do not have psychological clinical syndromes still experience worries, fears, anxiety, and other forms of psychological stress; they report fear about the future, inability to make plans, uncertainty, and a heightened sense of vulnerability.…”

Anxiety and Depression in Cancer Survivors

“…21 While most report few to no mood symptoms, almost 9% reported persistent depressive symptoms suggesting a clinical diagnosis of depression and almost 5% reported anxiety symptoms suggesting a clinical diagnosis of anxiety. Another group reported increasing symptoms over time: 10% for depression and almost 12% for anxiety.…”