Sex differences in depression for childhood cancer survivors

Abstract

Objective This study examines the differential association between sex and depression, and the possible mediating pathways. Methods We analysed survey data from 296 (age 7–17.1 years) cancer survivors from three centres affiliated with Beijing Children's Hospital. Linear regression analysis was used to assess the association between sex and depression. Quantile regression analysis was used to estimate the regression coefficients (β) and 95% confidence intervals for sex in depression at different quantiles. Mediation analysis with multiple mediators was used to explore the effects of sex on depression. Results Using linear regression, we found that the age ranged from 8.7 to 10.4 years and the regression coefficient of sex on depression was significant (β = −2.75, p = 0.03). Quantile regression results showed a significant negative association between sex and depression in the 0.30–0.75 quantiles. Mediation analysis revealed that boys were 1.545 times more depressed than girls, with family resilience, self‐perceived burden, and behavioural problems explaining approximately 16.79%, 21.57%, and 43.94% of the sex difference, respectively. The combined effect of family functioning, resilience, social support, self‐perceived burden, and behavioural problems might explain the 89.17% sex difference. Conclusion Clinicians should consider sex effects when assessing depression in childhood cancer survivors and target sex‐specific interventions for further treatment.

Longitudinal changes of psychological distress among childhood cancer survivors: The Swiss Childhood Cancer Survivor Study

“…Females, in general, are at higher risk for poorer psychological outcomes 5 . This sex/gender difference is multifactorial, from hormonal fluctuations (biological), societal pressures accorded to female gender (sociocultural), and differences in self‐reporting of psychological distress in questionnaires 37,38 . More notably, stress reaction is different, with females’ higher levels of psychological distress in response to stress compared to males 39 .…”

“…5 This sex/gender difference is multifactorial, from hormonal fluctuations (biological), societal pressures accorded to female gender (sociocultural), and differences in self-reporting of psychological distress in questionnaires. 37,38 More notably, stress reaction is different, with females' higher levels of psychological distress in response to stress compared to males. 39 On the other hand, male survivors exhibit more risky behaviors compared to females, such as smoking, binge-drinking, and illicit drug use, which may be a red flag for a mental health problem.…”