Barone Rita, Gulisano Mariangela, Cannata Emanuela, Padalino Sara, Saia Federica, Maugeri Nicoletta, Pettinato Fabio, Lo Nigro Luca, Casabona Antonino, Russo Giovanna, Di Cataldo Andrea, Rizzo Renata
Child Neuropsychiatry Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy.
Pediatric Oncohematology Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Catania, 95123 Catania, Italy.
J Clin Med. 2020 Oct 27;9(11):3444. doi: 10.3390/jcm9113444.
Pediatric cancer survivors are at increased risk for psychological distress. We sought to understand the severity and symptoms' co-occurrence among pediatric survivors compared to controls by rating both self- and parent-reported symptomatology. Forty survivors (22 males; mean age at study time: 12.9 years) participated in the study. Most survivors (85%) had a diagnosis of acute lymphoblastic leukemia. Seventy-nine healthy controls with the same age and gender distribution as the patients were included. A standardized assessment of psychological functioning was conducted by self- and parent-reported symptoms evaluations. The self-reported anxious symptom severity was significantly higher in survivors. A significantly higher proportion of survivors compared to controls had clinically significant anxiety, depression, and combined anxiety symptoms (i.e., social anxiety, separation anxiety, or physical symptoms). In both study groups, the self-reported emotional and somatic symptoms were significantly associated. The multi-informant assessments of the psychological symptoms revealed distinct associations between the child- and parent-reported symptoms in the survivors' group: the survivors' self-reports of depressive symptoms, somatic symptoms, and functional impairment were significantly correlated with the parent reports of child behavioral concerns, somatic complaints, and functional impairment, respectively. Conclusion: Self-reported symptoms showed similar comorbidity profiles in survivors and control peers. The multi-informant assessments detected differences in the association of self- and parent-reported symptoms between the survivor and control groups. The present study showed that multi-informant assessment is critical to understanding symptom profiles and to informing intervention with particular regard to parental participation and support.
儿童癌症幸存者出现心理困扰的风险更高。我们试图通过对自我报告和家长报告的症状进行评分,来了解与对照组相比,儿童幸存者心理困扰的严重程度以及症状的共现情况。40名幸存者(22名男性;研究时平均年龄:12.9岁)参与了该研究。大多数幸存者(85%)被诊断为急性淋巴细胞白血病。纳入了79名年龄和性别分布与患者相同的健康对照者。通过自我报告和家长报告的症状评估对心理功能进行标准化评估。幸存者自我报告的焦虑症状严重程度显著更高。与对照组相比,有显著更高比例的幸存者存在具有临床意义的焦虑、抑郁以及合并焦虑症状(即社交焦虑、分离焦虑或躯体症状)。在两个研究组中,自我报告的情绪和躯体症状显著相关。对心理症状的多渠道评估揭示了幸存者组中儿童报告症状与家长报告症状之间的不同关联:幸存者对抑郁症状、躯体症状和功能损害的自我报告分别与家长对儿童行为问题、躯体不适和功能损害的报告显著相关。结论:自我报告的症状在幸存者和对照同龄人中显示出相似的共病模式。多渠道评估发现幸存者组和对照组在自我报告症状与家长报告症状的关联方面存在差异。本研究表明,多渠道评估对于理解症状模式以及为干预提供信息至关重要,特别是在家长参与和支持方面。