Department of General Medicine, Hospices Civils de Lyon, Lyon, France.
Department of Psychiatry, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France.
J Adolesc Young Adult Oncol. 2020 Apr;9(2):247-255. doi: 10.1089/jayao.2019.0056. Epub 2019 Oct 29.
This study evaluated the long-term psychological impact of childhood cancer and also sought to identify the risk factors in the development of psychological issues. Young adult (18-38 years) survivors of a childhood cancer (except leukemia), diagnosed younger than 15 years between 1987 and 1999 in the Rhône-Alpes region of France, were invited to a semistandardized psychological interview after a medical follow-up consultation during two successive long-term follow-up studies in Oncology (SALTO-1 and -2). Psychiatric issues from the DSM-IV were diagnosed and compared with the general French population (GFP) through interviews based on the Mini-International Neuropsychiatric Interview (MINI). Of the 288 childhood cancer survivors (CCSs) who attended the consultations, 247 completed the MINI interview. Fifty-five percent indicated they had suffered from psychiatric issues after their cancer compared to 31.9% of the GFP ( < 0.0001). These issues were generally anxiety problems (40.5%), mood disorders (28.7%), and substance dependency (10.5%; < 0.0001). The risk of suicide was, however, less for the CCS group (8.9% vs. 13.6%, = 0.03). Unemployment was a significant risk factor for mood disorders ( = 0.009). Men were 4.1 times more likely than women to be addicted during their lifetime ( = 0.0004), while adults cured of bone tumors were 14.3 times more likely to be at risk of drug dependence than adults cured of central nervous system tumors ( = 0.01). CCSs are particularly vulnerable to psychiatric disorders throughout their life. Systematic and long-term psychological monitoring of these patients will enable their psychiatric issues to be detected sooner.
本研究评估了儿童癌症的长期心理影响,并试图确定心理问题发展的风险因素。法国罗纳-阿尔卑斯地区 1987 年至 1999 年间被诊断为 15 岁以下儿童癌症(除外白血病)的青年(18-38 岁)幸存者,在两次连续的肿瘤学长期随访研究(SALTO-1 和 -2)中的一次医学随访咨询后,被邀请参加半标准化的心理访谈。通过基于迷你国际神经精神病学访谈(MINI)的访谈,根据 DSM-IV 诊断精神疾病,并与一般法国人群(GFP)进行比较。在参加咨询的 288 名儿童癌症幸存者(CCSs)中,有 247 名完成了 MINI 访谈。55%的人表示他们在癌症后患有精神疾病,而 GFP 为 31.9%(<0.0001)。这些问题通常是焦虑问题(40.5%)、情绪障碍(28.7%)和物质依赖(10.5%;<0.0001)。然而,CCs 组自杀风险较低(8.9%比 13.6%,=0.03)。失业是情绪障碍的一个显著风险因素(=0.009)。男性一生中患物质依赖的可能性是女性的 4.1 倍(=0.0004),而治愈骨肿瘤的成年人患药物依赖的风险是治愈中枢神经系统肿瘤的成年人的 14.3 倍(=0.01)。CCS 一生中特别容易受到精神疾病的影响。对这些患者进行系统和长期的心理监测将使他们的精神问题能够更早被发现。