Bagur J, Massoubre C, Casagranda L, Faure-Conter C, Trombert-Paviot B, Berger C
Department of Psychiatry, University Hospital of Saint-Etienne, Saint-Etienne, France.
Pediatr Blood Cancer. 2015 May;62(5):847-53. doi: 10.1002/pbc.25425. Epub 2015 Feb 14.
Although psychological sequelae are well known among survivors of childhood cancer, psychiatric sequelae remain inadequately explored. Long-term psychiatric sequelae and their main risk factors in this population were evaluated.
Initially, 483 survivors of childhood cancer, except leukemia, were invited to complete a questionnaire assessing their health and quality of life. Of them, 130 completed the survey, subsequently consulted with a pediatric oncologist and an internist, and met with a psychologist for a semi-standardized interview based on the Mini International Neuropsychiatric Interview (MINI), which allowed diagnosis of DSM-IV Axis 1 psychiatric disorders. The collected data were compared with those of the French general population.
Seventy-three of the 130 survivors (56.2%) who completed the MINI interview reported experiencing at least one psychiatric disorder since cancer diagnosis, mostly anxiety (39.2%), mood (27.7%), or major depressive (24.6%) disorders; 46 reported at least one current disorder (35.4%). Agoraphobia (P = 0.02) and psychotic disorders were more common (P = 0.003) and general anxiety disorder less common (P < 0.001) among survivors than the general population. Most disorders correlated significantly with survivors' ratings of lower quality of life. Smoking, cancer type, and treatments significantly influenced the prevalence of psychiatric disorders.
Results were consistent between the self-questionnaire and MINI interview responses, though time may have biased memory. Vulnerability to and high risk for developing DSM-IV Axis 1 psychiatric disorders of childhood cancer survivors can persist long after diagnosis and treatment. Thus, systematic and general psychological screening of survivors may facilitate long-term psychological restoration.
尽管儿童癌症幸存者中广为人知存在心理后遗症，但精神后遗症仍未得到充分研究。对这一人群的长期精神后遗症及其主要风险因素进行了评估。
最初，邀请了483名除白血病外的儿童癌症幸存者填写一份评估其健康状况和生活质量的问卷。其中，130人完成了调查，随后咨询了儿科肿瘤学家和内科医生，并与心理学家进行了一次基于迷你国际神经精神病学访谈（MINI）的半标准化访谈，该访谈可诊断DSM-IV轴I精神障碍。将收集到的数据与法国普通人群的数据进行比较。
在完成MINI访谈的130名幸存者中，73人（56.2%）报告自癌症诊断以来至少经历过一种精神障碍，主要是焦虑症（39.2%）、情绪障碍（27.7%）或重度抑郁症（24.6%）；46人报告至少有一种当前存在的障碍（35.4%）。与普通人群相比，广场恐惧症（P = 0.02）和精神障碍在幸存者中更为常见（P = 0.003），而广泛性焦虑症则较少见（P < 0.001）。大多数障碍与幸存者对较低生活质量的评分显著相关。吸烟、癌症类型和治疗方法对精神障碍的患病率有显著影响。
自我问卷和MINI访谈的回答结果一致，尽管时间可能会影响记忆。儿童癌症幸存者患DSM-IV轴I精神障碍的易感性和高风险在诊断和治疗后可能会长期持续。因此，对幸存者进行系统和全面的心理筛查可能有助于长期的心理恢复。
