Psychopathological outcomes and defence mechanisms in clinically healed adults with a paediatric cancer history: an exploratory study

Abstract

BackgroundThe incidence of paediatric cancers has increased in recent years; however, with advances in the treatment of paediatric cancer, almost 80% of children and adolescents who receive a diagnosis of cancer become long-term survivors. Given the high stress levels associated with cancer, it becomes important to ascertain the risk and likelihood of psychiatric disorders in adult paediatric cancer survivors.AimsThis study aims to investigate the relationship between defence styles and predisposition to psychiatric diseases in adults with a history of paediatric cancer.MethodsWe performed an explorative study on a sample of 66 clinically healed adults with a history of paediatric cancer (survivors) during follow-up visits at the University Hospital ‘Policlinico G Rodolico’ of Catania (Italy) and 98 healthy controls among medicine students. We administered the Defence Mechanism Inventory (DMI) to assess defence styles. The Symptom Checklist-90-Revised (SCL-90-R) and the Davidson Trauma Scale (DTS) were administered to assess psychopathological indices. We conducted comprehensive statistical analysis based on correlation analysis and mediation analysis to investigate the relationship between defence styles and psychopathological outcomes in survivors compared with controls.ResultsThe survivors obtained statistically significant lower values in TAO, PRO and TAS defence styles and a higher value in REV. Both groups showed non-pathlogical mean scores in DTS and SCL-90-R (with an exception of the obsessive-compulsive subscale), with lower mean values among survivors. The results of mediation analysis showed that TAS had mediation effects on interpersonal sensitivity, anxiety, PSDI, GSI and avoidance, while TAO had mediation effects on DTS total score and intrusivity. Thus, for these psychopathological indices, the effect of the oncological pathology was indirect and mediated by TAO or TAS. Our analysis exlcluded mediation effects between the remaining variables and defence styles.ConclusionIntegrating data from mediation and correlation analysis, we found how the decreasing of TAS utilization in survivors as the consequence of cancer history, has decreased interpersonal sensitivity, anxiety and GSI score in these subjects compared with controls. Similary, the decrease of TAO utilization played a role in lower values of DTS total score and intrusivity subscale. Unexpectedly, our analysis excluded relationships between cancer history, other defence styles and psycopathological scores as we initially assumed.

Suicide trends among patients with cancer in India over the past 24 years

“…Conversely, some survivors of childhood cancer develop psychological stress-coping abilities over time. 13 The ability to cope with stress is the deciding factor for suicide. If stress becomes unbearable, it leads to suicide.…”

Risk factors for post-traumatic stress disorder among young and middle-aged cancer patients in the intensive care unit: A case-control study

“…Thus, the dual economic and psychological pressure can be even more torturous. Patients may feel guilty and self-blaming to their family members, and some even lose confidence in the future and request to give up the treatment; suicidal behaviors may occur[ 25 , 26 ]. These negative emotions make it difficult for patients to adjust their psychological stress levels, and patients become more susceptible to emotional disorders that can lead to PTSD.…”