Behavioral Symptoms and Psychiatric Disorders in Child and Adolescent Long-Term Survivors of Childhood Acute Lymphoblastic Leukemia Treated with Chemotherapy Only

Abstract

Background

Prevalence of emotional, behavioral and psychiatric outcomes in child and adolescent survivors of childhood acute lymphoblastic leukemia (ALL) treated on a chemotherapy-only protocol were not well defined.

Methods

Self- and parent-reported emotional and behavioral symptoms were assessed for 161 survivors of childhood ALL (51.0% female; mean [SD] age 12.1[2.6] years; 7.5[1.6] years post-diagnosis). Age- and sex-adjusted scores were calculated for standardized measures, and compared to 90^th percentile of norms. Frequencies of survivor psychiatric disorders from structured diagnostic interviews with parents were compared to the general population. Parent emotional distress and posttraumatic stress symptoms were assessed. Associations between child symptoms/disorders and parent distress were examined with log-binomial models, adjusting for highest parent education.

Results

Compared to population expectations (10%), more survivors self-reported symptoms of inattention (27.9; 95% CI 21.0-35.7%), hyperactivity/impulsivity (26.0%; CI 19.2-33.6%), and oppositional-defiant behavior (20.1%; CI 14.1-27.3%). Parents reported survivors with more symptoms of inattention (23.6%; CI 17.2-31.0%), higher frequencies of Obsessive-Compulsive Disorder (10.3% vs. 2%) and Oppositional Defiant Disorder (16.0% vs. 9.5%), but not Attention-Deficit/Hyperactivity Disorder (7.1% vs 7.8%) or Generalized Anxiety Disorder (3.2% vs. 4.1%), compared to national norms. Parent-report of child anxiety disorders was associated with parent self-reported emotional distress, but not survivor self-report of anxiety.

Conclusion

A significant minority of survivors have long-term psychiatric morbidity, multi-informant assessment is important to understand these symptom profiles and to inform selection of appropriate interventions. Interventions targeting inattention and oppositional behavior in children and emotional distress in parents are warranted in families with survivors who display behavioral problems.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2Hj8sV4