Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Str. 8, 55131 Mainz, Germany.
Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Str. 8, 55131 Mainz, Germany.
J Affect Disord. 2020 Mar 15;265:351-356. doi: 10.1016/j.jad.2020.01.080. Epub 2020 Jan 20.
Long-term childhood cancer survivors (CCS) are at risk for physical and psychosocial late effects. Previous research has attested to increased rates of suicidal ideation (SI) in CCS, an especially dangerous indicator of distress. However, little was known about risk factors of SI among CCS which go beyond illness- and treatment related variables.
A registry-based sample of 916 adult long-term CCS (M=34.58 years [SD=5.53], M=6.15 years [SD=4.28]) underwent medical assessments and filled out questionnaires. We conducted a linear regression analysis on SI, testing predictors of different areas: sociodemographic, social, physical health and health behavior, and psychological distress symptoms.
SI was reported by 73 (8.0%) CCS and previous suicide attempts were reported by 26 (2.8%) CCS. SI was most closely related to social and psychological factors, i.e. to concurrent distress symptoms (depression, anxiety, social phobia), previous suicide attempts, current loneliness, and the present living situation.
SI and previous suicide attempts were assessed using short self-report instruments. The cross-sectional study design does not allow for causal inferences.
Long-term CCS are a previously understudied, vulnerable group. Decades after having survived cancer, a considerable percentage is affected by (recurrent) SI. CCS' risk for SI is likely shaped by individual medical and psychological history, and by the current social environment and psychological comorbidities. There is a need for more interdisciplinary research and for screening efforts which take account of these factors. Interventions reducing CCS' risk of suicide should foster social integration and counteract current stressors.
长期儿童癌症幸存者（CCS）存在身体和心理社会晚期效应的风险。先前的研究证实 CCS 自杀意念（SI）的发生率增加，这是一种特别危险的痛苦指标。然而，人们对 CCS 的 SI 风险因素知之甚少，这些因素超出了与疾病和治疗相关的变量。
一项基于登记的 916 名成年长期 CCS（M=34.58 岁[SD=5.53]，M=6.15 岁[SD=4.28]）的样本进行了医学评估并填写了问卷。我们对 SI 进行了线性回归分析，测试了不同领域的预测因素：社会人口统计学、社会、身体健康和健康行为以及心理困扰症状。
73 名（8.0%）CCS 报告了 SI，26 名（2.8%）CCS 报告了以前的自杀企图。SI 与社会和心理因素最密切相关，即与当前的困扰症状（抑郁、焦虑、社交恐惧症）、以前的自杀企图、当前的孤独感和目前的生活状况。
SI 和以前的自杀企图是使用简短的自我报告工具评估的。横断面研究设计不允许进行因果推理。
长期 CCS 是一个以前研究不足的脆弱群体。在癌症幸存数十年后，相当一部分人受到（复发性）SI 的影响。CCS 发生 SI 的风险可能是由个人的医学和心理病史以及当前的社会环境和心理合并症决定的。需要进行更多的跨学科研究和筛查工作，以考虑这些因素。降低 CCS 自杀风险的干预措施应促进社会融合并应对当前的压力源。
