Psychological distress of adolescent and young adult childhood cancer survivors in a South African cohort

Abstract

Background We investigated psychological distress in a South African childhood cancer survivor (CCS) cohort. Methods Adult CCSs treated at Tygerberg Hospital, Cape Town, completed the Brief Symptom Inventory‐18. Internal consistency was acceptable: Cronbach's alpha values were 0.91 (Global Severity Index (GSI)), 0.85 (depression), 0.83 (somatization), and 0.75 (anxiety). We compared results utilizing different case rules (GSI T scores of ≥50, ≥57, and ≥63) for the identification of psychological distress. Results Forty CCSs (median age 24 years; median follow‐up period 16 years) participated. Most (58%; 23 out of 40) completed school or tertiary education, were unmarried (90%; 36 out of 40), and unemployed (59.5%; 22 out of 37). The diagnoses included hematological malignancies (65%; 26 out of 40) and solid tumors (35%; 14 out of 40). The GSI T scores of ≥63, ≥57, and ≥50 identified 10% (four out of 40), 32.5% (13 out of 40), and 45% (18 out of 40) of survivors with psychological distress, respectively. Radiotherapy (odds ratio (OR) 4.6; p = .035), presence of ≥six late effects (OR 7.5; p = .026), and severe late effects (OR 6.6; p = .024) were significant risk factors (GSI T score ≥57). Follow‐up period of 11–20 years (OR 7.3; p = .034) was significant for a GSI T score ≥50. Conclusion This South African CCS cohort had higher levels of psychological distress utilizing the GSI T score ≥50 and ≥57 case rules than reported in the literature. Most were unmarried or unemployed. Significant contributing factors were radiotherapy, number and severity of late effects, and follow‐up period. CCSs must be screened for psychological distress.

Screening for mental health problems in childhood cancer survivorship: a systematic review

“…The most frequently used tools in all domains were the Peds-QL (tools including psychological problems, but with a different overall focus), 27–31 the DT (distress), 29,36,40,42 the SCL-90 (distress), 11,27,40,43,44 and the BSI-18 (distress). 10,29,43–47…”

“…The most frequently used tools in all domains were the Peds-QL (tools including psychological problems, but with a different overall focus), [27][28][29][30][31] the DT (distress), 29,36,40,42 the SCL-90 (distress), 11,27,40,43,44 and the BSI-18 (distress). 10,29,[43][44][45][46][47] It seems to be a question of time and cost for clinicians, as well as for survivors and their families, how comprehensive screening can be in a clinical setting. It is questionable whether stand-alone screening tools should be used for each mental health condition.…”