Szabados Márton, Kolumbán Erika, Agócs Gergely, Kiss-Dala Szilvia, Engh Marie Anne, Hernádfői Márk, Takács Kata, Tuboly Eszter, Párniczky Andrea, Hegyi Péter, Garami Miklós
Pediatric Center, Semmelweis University, 7-9 Tűzoltó Street, Budapest, 1094, Hungary.
Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Child Adolesc Psychiatry Ment Health. 2023 Oct 27;17(1):124. doi: 10.1186/s13034-023-00665-0.
This study aimed to evaluate the association between the location (supratentorial or infratentorial) of brain tumors and the development of depression and anxiety in childhood cancer survivors. Understanding the risk factors for the development of depression and anxiety disordersin these patients is crucial for early diagnosis and successful treatment.
The meta-analysis included articles that listed patients diagnosed with an intracranial tumor before the age of 18 years, provided the location of the tumor, had exact data on the prevalence of anxiety and depression, or measured these disorders using different assessment tools. The search was conducted in five different databases (MEDLINE, Embase, Web of Science, Scopus, and Cochrane Library). Risk of bias was assessed using QUIPS-2. Outcome measures used were prevalences and standardized means.
The analysis included 42 eligible articles with a total number of 1071 patients. Relevant articles were cohort studies, cross-sectional studies, and case series. Based on the available data infratentorial brain tumor survivors had significantly higher scores on various assessment tools measuring anxiety (MRAW (raw mean scores): 36.24 [CI (confidence interval): 28.81-43.67]; versus MRAW: 23.21 (CI 0.91-45.51); p = 0.02, and depression (MRAW: 27.57 (CI 14.35-40.78) versus MRAW: 13.84 (CI 11.43-16.26); p < 0.01.
Childhood infratentorial cancer survivors have more impairments in terms of depression and anxiety; these children and adults should be monitored more frequently and may require closer follow-up on their mental health. The main limitation of our study originates from the lack of data on follow-up times used by different studies.
本研究旨在评估脑肿瘤的位置(幕上或幕下)与儿童癌症幸存者抑郁和焦虑发展之间的关联。了解这些患者发生抑郁和焦虑障碍的风险因素对于早期诊断和成功治疗至关重要。
荟萃分析纳入了列出18岁前被诊断患有颅内肿瘤的患者、提供肿瘤位置、有焦虑和抑郁患病率的确切数据或使用不同评估工具测量这些障碍的文章。检索在五个不同的数据库(MEDLINE、Embase、科学网、Scopus和Cochrane图书馆)中进行。使用QUIPS-2评估偏倚风险。所使用的结局指标为患病率和标准化均值。
分析包括42篇符合条件的文章,共1071例患者。相关文章为队列研究、横断面研究和病例系列。根据现有数据,幕下脑肿瘤幸存者在各种测量焦虑的评估工具上得分显著更高(原始平均得分:36.24[置信区间:28.81 - 43.67];相比原始平均得分:23.21(置信区间0.91 - 45.51);p = 0.02),以及抑郁(原始平均得分:27.57(置信区间14.35 - 40.78)相比原始平均得分:13.84(置信区间11.43 - 16.26);p < 0.01)。
儿童幕下癌症幸存者在抑郁和焦虑方面有更多损害;这些儿童和成人应更频繁地接受监测,可能需要对其心理健康进行更密切的随访。我们研究的主要局限性源于不同研究使用的随访时间数据不足。