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Prevalence and predictors of anxiety and depression after completion of chemotherapy for childhood acute lymphoblastic leukemia: A prospective longitudinal study
Author(s) -
KuninBatson Alicia S.,
Lu Xiaomin,
Balsamo Lyn,
Graber Kelsey,
Devidas Meenakshi,
Hunger Stephen P.,
Carroll William L.,
Winick Naomi J.,
Mattano Leonard A.,
Maloney Kelly W.,
KadanLottick Nina S.
Publication year - 2016
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.29946
Subject(s) - medicine , anxiety , odds ratio , depression (economics) , longitudinal study , prospective cohort study , confidence interval , distress , coping (psychology) , population , pediatrics , psychiatry , clinical psychology , environmental health , pathology , economics , macroeconomics
BACKGROUND The months immediately after the completion of treatment for childhood acute lymphoblastic leukemia (ALL) are often regarded as a stressful time for children and families. In this prospective, longitudinal study, the prevalence and predictors of anxiety and depressive symptoms after the completion of treatment were examined. METHODS Participants included 160 children aged 2 to 9 years with standard‐risk ALL who were enrolled on Children's Oncology Group protocol AALL0331. Parents completed standardized rating scales of their children's emotional‐behavioral functioning and measures of coping and family functioning at approximately 1 month, 6 months, and 12 months after diagnosis and again 3 months after the completion of chemotherapy. RESULTS At 3 months off therapy, approximately 24% of survivors had at‐risk/clinically elevated anxiety scores and 28% had elevated depression scores, which are significantly higher than the expected 15% in the general population ( P = .028 and .001, respectively). Patients with elevated anxiety 1 month after diagnosis were at greater risk of off‐therapy anxiety (odds ratio, 4.1; 95% confidence interval, 1.31‐12.73 [ P = .022]) and those with elevated depressive symptoms 6 months after diagnosis were at greater risk of off‐therapy depression (odds ratio, 7.88; 95% confidence interval, 2.61‐23.81 [ P = .0002]). In adjusted longitudinal analyses, unhealthy family functioning ( P = .008) and less reliance on social support coping ( P = .009) were found to be associated with risk of emotional distress. Children from Spanish‐speaking families ( P = .05) also were found to be at a greater risk of distress. CONCLUSIONS A significant percentage of children experience emotional distress during and after therapy for ALL. These data provide a compelling rationale for targeted early screening and psychosocial interventions to support family functioning and coping skills. Cancer 2016;122:1608–17 . © 2015 American Cancer Society .