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. 2013 Sep 3;109(5):1373-81.
doi: 10.1038/bjc.2013.428. Epub 2013 Jul 23.

Longitudinal patterns of psychological distress in adult survivors of childhood cancer

T M Brinkman  1 , L Zhu, L K Zeltzer, C J Recklitis, C Kimberg, N Zhang, A C Muriel, M Stovall, D K Srivastava, L L Robison, K R Krull
Affiliations

Longitudinal patterns of psychological distress in adult survivors of childhood cancer

T M Brinkman et al. Br J 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.

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Figures

Figure 1
Figure 1
Consort diagram of study participation. BSI-18=Brief Symptom Inventory.
Figure 2
Figure 2
Longitudinal classes of distress symptoms across baseline and two follow-up time points. Vertical axis depicts average T-score (expected mean=50; s.d.=10) for each class at various time points. (A) Depressive symptoms. (B) Anxiety symptoms. (C) Somatic symptoms.
See this image and copyright information in PMC

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