Kaye Erica C, Brinkman Tara M, Baker Justin N
Department of Oncology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop 260, Memphis, TN, 38105, USA.
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA.
Support Care Cancer. 2017 Jun;25(6):2009-2017. doi: 10.1007/s00520-017-3659-y. Epub 2017 Mar 9.
As therapeutic and supportive care interventions become increasingly effective, growing numbers of childhood and adolescent cancer survivors face a myriad of physical and psychological sequelae secondary to their disease and treatment. Mental health issues, in particular, present a significant problem in this unique patient population, with depression affecting a sizable number of childhood and adolescent cancer survivors. Multiple key determinants impact a survivor's risk of developing depression, with variables traversing across biologic, individual, family, community, and global levels, as well as spanning throughout the life course of human development from the preconception and prenatal periods to adulthood. A multi-level life course conceptual model offers a valuable framework to identify and organize the diverse variables that modulate the risk of developing depression in survivors of childhood and adolescent cancer. This review describes the first multi-level life course perspective applied to development of depression in childhood and adolescent cancer survivors. This conceptual framework may be used to guide the investigation of mental health interventions for SCACs to ensure that key determinants of depression occurrence are adequately addressed across various levels and throughout the life trajectory.
随着治疗和支持性护理干预措施变得越来越有效，越来越多的儿童和青少年癌症幸存者面临着因疾病和治疗而产生的众多身体和心理后遗症。特别是心理健康问题，在这个独特的患者群体中是一个重大问题，抑郁症影响着相当数量的儿童和青少年癌症幸存者。多个关键决定因素会影响幸存者患抑郁症的风险，这些变量涵盖生物、个人、家庭、社区和全球层面，并且贯穿人类发展的整个生命历程，从孕前和孕期到成年期。一个多层次的生命历程概念模型为识别和组织调节儿童和青少年癌症幸存者患抑郁症风险的各种变量提供了一个有价值的框架。本综述描述了首个应用于儿童和青少年癌症幸存者抑郁症发展的多层次生命历程视角。这个概念框架可用于指导对儿童和青少年癌症幸存者心理健康干预措施的研究，以确保在各个层面和整个生命轨迹中充分解决抑郁症发生的关键决定因素。
