Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215, USA.
J Neurooncol. 2013 Jul;113(3):425-32. doi: 10.1007/s11060-013-1130-6. Epub 2013 Apr 27.
Survivors of pediatric brain tumors are at risk for long-term psychological morbidities. The current study investigated the prevalence and predictors of suicide ideation (SI) in a clinical sample of youth and adult survivors. Retrospective chart reviews were completed for 319 survivors of pediatric brain tumors who were assessed via clinical interview during routine neuro-oncology clinic visits between 2003 and 2007. Survivors were, on average, 18.0 years of age (SD = 4.9) and 10 years from diagnosis (SD = 5.0) at their most recent follow-up. The most common diagnosis was low-grade glioma (n = 162) followed by embryonal tumors (PNET/medulloblastoma; n = 64). Multivariable logistic regression was used to calculate odds ratios (OR) and 95 % confidence intervals (CI) for SI. Nearly 12 % of survivors (11.7 %, n = 37) reported SI. Five survivors (1.5 %) had documented suicide attempts, though none were fatal. In a multivariable model, adjusting for sex and age, history of depression (OR = 20.6, 95 % CI = 4.2-101.1), psychoactive medication treatment (OR = 4.5, 95 % CI = 1.8-11.2), observation or surgery only treatment (OR = 3.7, 95 % CI = 1.5-9.1), and seizures (OR = 3.6, 95 % CI = 1.1-11.1) were significantly associated with SI in survivors. Survivors of pediatric brain tumors appear to be at risk for experiencing SI. Our results underscore the importance of a multidisciplinary approach to providing follow-up care for childhood brain tumor survivors, including routine psychological screenings.
儿童脑肿瘤幸存者存在长期心理病态的风险。本研究调查了在 2003 年至 2007 年间通过临床访谈评估的儿科脑肿瘤青年和成年幸存者临床样本中自杀意念 (SI) 的患病率和预测因素。对 319 名患有儿科脑肿瘤的幸存者进行了回顾性图表审查，这些幸存者在常规神经肿瘤学诊所就诊期间接受了临床访谈。幸存者的平均年龄为 18.0 岁（SD=4.9），最近一次随访时距诊断时间为 10 年（SD=5.0）。最常见的诊断是低级别胶质瘤（n=162），其次是胚胎性肿瘤（PNET/髓母细胞瘤；n=64）。多变量逻辑回归用于计算 SI 的优势比 (OR) 和 95%置信区间 (CI)。近 12%的幸存者（11.7%，n=37）报告有 SI。有 5 名幸存者（1.5%）有记录的自杀企图，但均未致命。在多变量模型中，调整性别和年龄后，抑郁史（OR=20.6，95%CI=4.2-101.1）、精神活性药物治疗（OR=4.5，95%CI=1.8-11.2）、观察或仅手术治疗（OR=3.7，95%CI=1.5-9.1）和癫痫发作（OR=3.6，95%CI=1.1-11.1）与幸存者的 SI 显著相关。儿童脑肿瘤幸存者似乎有出现 SI 的风险。我们的结果强调了对儿童脑肿瘤幸存者提供随访护理的多学科方法的重要性，包括常规心理筛查。
