Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Nov 11;10(6):e207.
doi: 10.1192/bjo.2024.805.

Post-traumatic stress disorder and symptoms in paediatric cancer survivors and their family nucleus: systematic review, meta-analysis and meta-regression

Chen Ee Low  1 , Sheryl Yen Pin Tan  1 , Andre Loh  1 , Jingrong Yu  1 , Joel Zuo Er Ong  1 , Caitlin Yuen Ling Loh  1 , Chun En Yau  1 , Ainsley Ryan Yan Bin Lee  1 , Cyrus Su Hui Ho  2
Affiliations
Review

Post-traumatic stress disorder and symptoms in paediatric cancer survivors and their family nucleus: systematic review, meta-analysis and meta-regression

Chen Ee Low et al. BJPsych Open. .

Abstract

Background: Various studies have highlighted the increased incidence and symptoms of depression and anxiety in paediatric cancer survivors (PCS). Yet no meta-analysis has focused on post-traumatic stress disorder (PTSD) or post-traumatic stress symptoms (PTSS) in PCS and their family nucleus.

Aims: To evaluate the overall risk of PTSD and severity of PTSS in PCS and their family nucleus. Secondary objectives include identifying potential risk factors of PTSD and high PTSS.

Method: We systematically searched PubMed, Embase and PsycINFO for studies comparing the risk of PTSD and PTSS severity among PCS, their family nucleus and non-cancer controls. PRISMA reporting guidelines were followed. Random effects meta-analyses and meta-regressions were conducted.

Results: From 1089 records, we included 21 studies. PCS have an increased risk of PTSD (risk ratio 2.36, 95% CI 1.37-4.06) and decreased PTSS severity (standardised mean difference -0.29, 95% CI -0.50 to -0.08). Subgroup analyses of other categorical study-level characteristics revealed that female PCS who were older at diagnosis and data collection had a significantly higher risk of PTSD. Meta-regression were insignificant. Family nucleus did not show a significantly increased risk of PTSD (risk ratio 1.13, 95% CI 0.59-5.00) and PTSS severity (standardised mean difference 0.53, 95% CI -0.00 to 1.06). Systematically reviewing studies on the family nucleus found that the majority reported a significantly increased risk of psychological trauma compared with the comparator. Lower education, income and social status were also risk factors.

Conclusions: Timely identification and interventions are imperative for policy makers and healthcare providers to prevent trauma from worsening in this population group.

Keywords: Trauma and stressor-related disorders; carers; child and adolescent psychiatry; meta-analysis; systematic review.

PubMed Disclaimer

Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart.
Fig. 2
Fig. 2
Incidence and risk ratios of post-traumatic stress disorder in paediatric cancer survivors compared with non-cancer controls. Survivors refers to studies with a population of paediatric cancer survivors.
Fig. 3
Fig. 3
Mean severity of post-traumatic stress symptoms in paediatric cancer survivors compared with non-cancer controls. Survivors refers to studies with a population of paediatric cancer survivors. SMD, standardised mean difference.
Fig. 4
Fig. 4
Incidence and risk ratios of post-traumatic stress disorder in the family nucleus of paediatric cancer survivors compared with non-cancer controls. Family nucleus refers to studies with a population of family nucleus of paediatric cancer survivors.
Fig. 5
Fig. 5
Mean severity of post-traumatic stress symptoms in the family nucleus of paediatric cancer survivors compared with non-cancer controls. Family nucleus refers to studies with a population of family nucleus of paediatric cancer survivors. SMD, standardised mean difference.
See this image and copyright information in PMC

References

    1. Bray F, Laversanne M, Weiderpass E, Soerjomataram I. The ever-increasing importance of cancer as a leading cause of premature death worldwide. Cancer 2021; 127(16): 3029–30. - PubMed
    1. Steliarova-Foucher E, Colombet M, Ries LAG, Moreno F, Dolya A, Bray F, et al. International incidence of childhood cancer, 2001–10: a population-based registry study. Lancet Oncol 2017; 18(6): 719–31. - PMC - PubMed
    1. Smith MA, Altekruse SF, Adamson PC, Reaman GH, Seibel NL. Declining childhood and adolescent cancer mortality. Cancer 2014; 120(16): 2497–506. - PMC - PubMed
    1. Ahomäki R, Gunn ME, Madanat-Harjuoja LM, Matomäki J, Malila N, Lähteenmäki PM. Late psychiatric morbidity in survivors of cancer at a young age: a nationwide registry-based study. Int J Cancer 2015; 137(1): 183–92. - PubMed
    1. Tremolada M, Bonichini S, Basso G, Pillon M. Post-traumatic stress symptoms and post-traumatic growth in 223 childhood cancer survivors: predictive risk factors. Front Psychol 2016; 7: 287. - PMC - PubMed

LinkOut - more resources