Oh Yunhye, Seo Hyunjung, Sung Ki Woong, Joung Yoo Sook
Departments of *Psychiatry †Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Pediatr Hematol Oncol. 2017 Mar;39(2):e46-e53. doi: 10.1097/MPH.0000000000000766.
To examine the psychosocial outcomes and impact of attention problems in survivors of pediatric brain tumor.
The survivors' cognitive functioning was measured using the Wechsler Intelligence Scale for Children. The Child Behavior Checklist-Attention Problems scale was used to screen for attention problems, and participants were classified as having attention problems (n=15) or normal attention (n=36). Psychosocial functioning was examined with the Korean Personality Rating scale for Children (K-PRC) at precraniospinal radiation and at 2-year follow-up.
The attention problem group showed significantly higher depression and externalizing symptoms (delinquency, hyperactivity) and more significant impairment in family relationships than did the normal attention group at baseline. At follow-up, the attention problem group demonstrated significantly more delinquency and impaired family and social relationships. With the K-PRC scores, except for the somatization, social relationship subscale, there were significant differences between groups, but not in terms of treatment by time interaction or within time. At follow-up, multiple linear regressions showed that age at diagnosis significantly predicted K-PRC somatization (B=-1.7, P=0.004) and social relationships (B=-1.7, P=0.004), baseline full-scale intelligence quotient predicted K-PRC depression (B=-0.4, P=0.032) and somatization (B=-0.3, P=0.015), and attention problems at baseline predicted K-PRC depression (B=-15.2, P=0.036) and social relationships (B=-11.6, P=0.016).
Pediatric brain tumor survivors, in particular, patients with attention problems, had worse psychosocial functioning at baseline and follow-up. Attention problems at baseline need to be carefully evaluated in assessing psychosocial functioning of pediatric brain tumor survivors.
探讨小儿脑肿瘤幸存者的心理社会结局及注意力问题的影响。
采用韦氏儿童智力量表测量幸存者的认知功能。使用儿童行为清单 - 注意力问题量表筛查注意力问题，参与者被分为有注意力问题组（n = 15）和注意力正常组（n = 36）。在颅脊髓放疗前和2年随访时，使用韩国儿童人格评定量表（K - PRC）检查心理社会功能。
在基线时，注意力问题组的抑郁和外化症状（犯罪、多动）显著高于注意力正常组，家庭关系受损也更明显。在随访时，注意力问题组的犯罪行为以及家庭和社会关系受损更为显著。对于K - PRC评分，除躯体化、社会关系子量表外，两组之间存在显著差异，但在时间交互作用或时间内治疗方面无差异。在随访时，多元线性回归显示，诊断时的年龄显著预测K - PRC躯体化（B = -1.7，P = 0.004）和社会关系（B = -1.7，P = 0.004），基线全量表智商预测K - PRC抑郁（B = -0.4，P = 0.032）和躯体化（B = -0.3，P = 0.015），基线时的注意力问题预测K - PRC抑郁（B = -15.2，P = 0.036）和社会关系（B = -11.6 , P = 0.016）。
小儿脑肿瘤幸存者，尤其是有注意力问题的患者，在基线和随访时的心理社会功能较差。在评估小儿脑肿瘤幸存者的心理社会功能时，需要仔细评估基线时的注意力问题。
