Korenblum Chana, Taylor Rachel M, Fern Lorna A, Hough Rachael, Wickramasinghe Bethany
The Hospital for Sick Children, Princess Margaret Cancer Centre, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5G1X8, Canada.
Centre for Nurse, Midwife and Allied Health Profession Led Research (CNMAR), University College London Hospitals NHS Foundation Trust, Department of Targeted Intervention, University College London, London NW1 2PG, UK.
Cancers (Basel). 2025 Mar 31;17(7):1196. doi: 10.3390/cancers17071196.
BACKGROUND/OBJECTIVES: AYAs face unique psychosocial challenges compared to younger children and older adults. Little published data exists about symptoms of psychological distress in AYAs, particularly in large cohorts over time. This study aimed to (1) explore relationships between distress and variables known to impact mental health, (2) examine distress over time, and (3) consult with a patient and public involvement group (Young Advisory Panel, YAP) to contextualize the results.
Secondary data analyses were conducted from a multicentre longitudinal cohort study, which recruited 830 participants aged 13-24 years newly diagnosed with different cancers. The mean age was 20.1 (SD 3.3) and 45% were female. Bespoke surveys, including a validated measure of psychosocial distress, were administered five times over 3 years following diagnosis. Participatory workshops were conducted with the YAP to gather their impressions of the study results and inform conclusions.
At the first time point, higher social support was associated with higher distress scores (β = 0.202, < 0.001) and AYAs with higher depressive symptoms were more likely to see a mental health professional ( < 0.01). Over time, anxiety symptoms remained stable ( = 0.090); however, depressive symptoms improved ( < 0.001). The YAP highlighted the mixed effects of social support and the under-recognition and undertreatment of distress.
This information identifies key targets, such as social support, that can inform the design of personalized screening and intervention tools. It also highlights specific timepoints at which these efforts can be directed to mitigate distress and improve quality of life. Future research should include longer-term follow-up, qualitative explorations of distress along the disease trajectory, and ongoing co-production efforts.
背景/目的：与年幼儿童和老年人相比，青少年和青年成人（AYAs）面临独特的心理社会挑战。关于AYAs心理困扰症状的公开数据很少，尤其是随着时间推移在大型队列中的情况。本研究旨在：（1）探讨困扰与已知影响心理健康的变量之间的关系；（2）随时间检查困扰情况；（3）与患者及公众参与小组（青年咨询小组，YAP）协商，以使结果具有背景意义。
对一项多中心纵向队列研究进行二次数据分析，该研究招募了830名新诊断出患有不同癌症的13 - 24岁参与者。平均年龄为20.1岁（标准差3.3），45%为女性。在诊断后的3年中，进行了5次定制调查，包括一项经过验证的心理社会困扰测量。与YAP举办了参与性研讨会，以收集他们对研究结果的看法并为结论提供信息。
在第一个时间点，更高的社会支持与更高的困扰得分相关（β = 0.202，P < 0.001），且抑郁症状较高的AYAs更有可能寻求心理健康专业人员的帮助（P < 0.01）。随着时间的推移，焦虑症状保持稳定（P = 0.090）；然而，抑郁症状有所改善（P < 0.001）。YAP强调了社会支持的混合效应以及对困扰的认识不足和治疗不足。
这些信息确定了关键目标，如社会支持，可为个性化筛查和干预工具的设计提供信息。它还突出了可针对这些努力以减轻困扰和改善生活质量的特定时间点。未来的研究应包括长期随访、对疾病轨迹上困扰的定性探索以及持续的共同生产努力。
