Prevalence of mental disorders and psychosocial distress in German adolescent and young adult cancer patients (AYA)

Geue, Kristina; Brähler, Elmar; Faller, Hermann; Härter, Martin; Schulz, Holger; Weis, Joachim; Koch, Uwe; Wittchen, Hans‐Ulrich; Mehnert, Anja

doi:10.1002/pon.4730

Cited by 68 publications

(56 citation statements)

References 32 publications

(92 reference statements)

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“…The selected scores are optimized to achieve the best sensitivity and specificity for identification of patients with distress. Briefly, levels of distress with specified time points were assessed on a Likert Scale (Not at all ''0'' to very much ''5''), and mean scores were calculated and divided into low, 1-7 moderate, [8][9][10] and severe (>10) symptoms of anxiety or depression. 13,14 Statistical analysis A 3:1 case match based on gender, primary tumor site, and metastatic status was performed with older adults (>40 years old) and AYA (18-40 years old).…”

Section: Methodsmentioning

confidence: 99%

“…6 There is evidence that among AYA, distress can lead to reduced treatment compliance, 7 which may correlate with poorer health outcomes in this vulnerable population. Although AYA needs have been studied at different time points on their illness trajectory, 5,6,[8][9][10] there is limited understanding of distress experienced by AYA at diagnosis compared to older adults.…”

Section: Introductionmentioning

confidence: 99%

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Distinct Features of Psychosocial Distress of Adolescents and Young Adults with Cancer Compared to Adults at Diagnosis: Patient-Reported Domains of Concern

Smrke¹,

Leung²,

Srikanthan

et al. 2020

Journal of Adolescent and Young Adult Oncology

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Purpose: Adolescents and young adults (AYA) (18-40) are a population of patients with cancer, who have distinctive developmental and psychosocial pressures. Using validated distress screening tools, we investigated psychosocial needs of AYA compared to older adults with cancer at diagnosis. Methods: AYA and older adult patients from British Columbia, Canada, between 2011 and 2016, who completed the Canadian Problem Checklist (CPC) and the PsychoSocial Screen for Cancer-Revised (PSSCAN-R) within 6 months of their cancer diagnosis were included in the study. Emotional, informational, physical, practical, social, and spiritual domain concerns are identified using the CPC. Psychosocial needs and distress are evaluated using the PSSCAN-R. Baseline demographics were obtained from the cancer registry. Based on gender, primary tumor site, and presence of metastasis, a 3:1 case match was performed with older adults (>40 years old). Statistical analyses included Chi square and Fisher's exact tests. Results: Two thousand and forty five AYA were case matched with 6050 older adults. Majority of patients were female (61.9%), and at diagnosis, 12.1% had metastatic disease. Top three tumor types were breast (20.4%), lymphoma (11.5%), and gastrointestinal (10.8%). The top five concerns for AYA (% AYA, % adults) were fear/worry (56.6, 42.9), understanding of illness (47.6, 41.4), sleep (35.2, 28.9), sadness (34.1, 20.0), and finances (33.8, 15.0). AYA reported higher symptoms of anxiety at baseline (% AYA, % older adults), both moderate (26.0, 19.9) and severe (26.6, 17.1) p < 0.01. Conclusion: Significant differences in psychosocial needs for AYA were seen at diagnosis across multiple domains, specifically, higher emotional, informational, physical, and financial distress. Development of supportive programming geared toward these domains early at diagnosis could benefit this distinct population.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Distinct Features of Psychosocial Distress of Adolescents and Young Adults with Cancer Compared to Adults at Diagnosis: Patient-Reported Domains of Concern

Smrke¹,

Leung²,

Srikanthan

et al. 2020

Journal of Adolescent and Young Adult Oncology

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“…In addition, AYA patients express a need for improved mental health and support group services . Studies have found that almost one‐third of AYA patients with cancer endorse increased depressive symptoms . Having unmet psychosocial needs is associated with worse health‐related quality of life, fatigue, and poor work/school functioning .…”

Section: Improving Outcomes Of Ayas With Cancermentioning

confidence: 99%

“…14,80 Studies have found that almost onethird of AYA patients with cancer endorse increased depressive symptoms. 81,82 Having unmet psychoso cial needs is associated with worse healthrelated quality of life, fatigue, and poor work/school functioning. 14 Addressing these needs is difficult with the current mental health infra structure in the United States, especially when mental health care remains an underserved area of the US health system.…”

Section: Psychosocial Factorsmentioning

confidence: 99%

Adolescent and young adult oncology—past, present, and future

Dreyzin

Miller

et al. 2019

CA A Cancer J Clinicians

144

110

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There are nearly 70,000 new cancer diagnoses made annually in adolescents and young adults (AYAs) in the United States. Historically, AYA patients with cancer, aged 15 to 39 years, have not shown the same improved survival as older or younger cohorts. This article reviews the contemporary cancer incidence and survival data through 2015 for the AYA patient population based on the National Cancer Institute's Surveillance, Epidemiology, and End Results registry program and the North American Association of Central Cancer Registries. Mortality data through 2016 from the Centers for Disease Control and Prevention's National Center for Health Statistics are also described. Encouragingly, absolute and relative increases in 5‐year survival for AYA cancers have paralleled those of childhood cancers since the year 2000. There has been increasing attention to these vulnerable patients and improved partnerships and collaboration between adult and pediatric oncology; however, obstacles to the care of this population still occur at multiple levels. These vulnerabilities fall into 3 significant categories: research efforts and trial enrollment directed toward AYA malignancies, access to care and insurance coverage, and AYA‐specific psychosocial support. It is critical for providers and health care delivery systems to recognize that the AYA population remains vulnerable to provider and societal complacency.

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“…23 Older patients also experience comorbid conditions alongside their cancer, as well as associated reductions in independence. 24,25 However, it is not clear which age groups may be more psychologically ''vulnerable'' in the context of a DTC diagnosis. While middle-aged and older cancer patients have more life experience than AYAs, this could possibly influence their psychological distress and illness perceptions positively (e.g., through having a greater set of learned coping strategies and more social resources) or negatively (e.g., through having witnessed more peers or family members with poor health or cancer outcomes).…”

Section: Introductionmentioning

confidence: 99%

Psychological Distress and Illness Perceptions in Thyroid Cancer Survivors: Does Age Matter?

Husson

Poort

Sansom-Daly

et al. 2020

Journal of Adolescent and Young Adult Oncology

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Purpose: To examine the role of differentiated thyroid cancer (DTC) patients' age in illness perceptions and psychological distress, and the potential moderating role of age in the relationship between illness perceptions and psychological distress. Methods: We used the Netherlands Cancer Registry to select all patients diagnosed with thyroid cancer between 1990 and 2008 (n = 568). Patients filled out the Hospital Anxiety and Depression Scale (HADS) and Brief Illness Perception Questionnaire. Levels of psychological distress and illness perceptions were compared between the different DTC survivor age groups (adolescents and young adults [AYAs; 18-39 years], middleaged adults [40-64 years], and older survivors [65-84 years]). Results: Among 293 respondents with DTC, AYAs (n = 84) had more faith in the fact that their treatment can help them, and reported a stronger belief in understanding their illness compared to middle-aged (n = 172) and older adults (n = 37). No differences regarding age were seen on the other six illness perception subscales. AYAs did report significantly less distress (HADS caseness = 13.8%) compared to middle-aged (28.7%) and older adults (22.2%). Most illness perception subscales were associated with distress and the associations with age were mixed. AYAs and older patients who believed that their illness would continue for a long time reported more distress, but this association was not found for the middle-aged group. Conclusion: Illness perceptions play a key role in the experience of distress years after diagnosis and this is related to age. AYA and older cancer patients may be particularly vulnerable to distress related to maladaptive cancer-related beliefs/perceptions.

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Prevalence of mental disorders and psychosocial distress in German adolescent and young adult cancer patients (AYA)

Abstract: Our findings may sensitize clinicians to the possible presence of mental disorders in AYA. The results indicate that there is a strong need for psycho-oncological interventions designed to improve mental health in AYAs with cancer at all stages of medical care.

Cited by 68 publications

References 32 publications

Distinct Features of Psychosocial Distress of Adolescents and Young Adults with Cancer Compared to Adults at Diagnosis: Patient-Reported Domains of Concern

Distinct Features of Psychosocial Distress of Adolescents and Young Adults with Cancer Compared to Adults at Diagnosis: Patient-Reported Domains of Concern

Adolescent and young adult oncology—past, present, and future

Psychological Distress and Illness Perceptions in Thyroid Cancer Survivors: Does Age Matter?

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