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Psychological Outcomes in Long-Term Survivors
of Childhood Brain Cancer: A Report From the Childhood Cancer Survivor Study
Brad
J. Zebrack, James G. Gurney, Kevin Oeffinger, John Whitton, Roger J. Packer, Ann
Mertens, Norman Turk, Robert Castleberry, ZoAnn Dreyer, Leslie L. Robison,
Lonnie K. Zeltzer
From
the University of Southern California School of Social Work; the Department of
Pediatrics, David Geffen School of Medicine, University of California Los
Angeles, Los Angeles, CA; the Department of Pediatrics, University of Minnesota,
Minneapolis, MN; the University of Texas Southwestern Medical Center, Dallas;
Texas Children's Hospital, Houston, TX; the University of Washington, Seattle,
WA; the Departments of Neurology and Pediatrics, Children's National Medical
Center; The George Washington University, Washington, DC; and the Department of
Pediatrics, School of Medicine, University of Alabama, Birmingham, AL. Address
reprint requests to Brad Zebrack, PhD, USC School of Social Work, 669 W 34th St,
Los Angeles, CA 90089-0411; e-mail: zebrack@usc.edu
Purpose.
To evaluate and compare psychological outcomes in long-term survivors
of pediatric brain cancer and siblings of childhood cancer survivors,
and to identify significant correlates of psychological distress.
Methods.
One thousand one hundred one adult survivors of childhood brain cancer
and 2,817 siblings completed a long-term follow-up questionnaire allowing
assessment of symptoms associated with depression, somatization, and
anxiety, as well as demographic, health, and medical information.
Results.
A large majority of siblings and survivors report few, if any, symptoms
of psychological distress.
The prevalence of distress approximating clinically significant
levels for both survivors (11%) and siblings (5%) reflects rates
found in the general population.
Yet when accounting for significant sociodemographic, socioeconomic,
and health-status variables, survivors of childhood brain cancer, in
the aggregate, appear to report significantly higher global distress
and depression scores than do siblings.
As in the general population, higher levels of distress among survivors
and siblings were associated with female sex, low household income,
lower educational attainment, being unmarried, not being employed in
the past 12 months, and poor physical health status.
No diagnostic or treatment-related variables were directly and
significantly associated with increases in distress symptoms for
survivors of childhood brain cancer.
Conclusion.
Cancer treatment does not appear to contribute directly to increased psychological
distress.
Instead, distress appears to be associated with diminished social
functioning that may be related to cancer type or treatment.
Implementation and evaluation of supportive interventions that
enhance survivors' social and vocational skills should be considered.
Supported
by the National Cancer Institute of the National Institutes of Health
(grant U24 CA55727) and the Children's Cancer Research Fund (L.L.R.);
by the Lance Armstrong Foundation (L.K.Z.); and by a National
Research Service Award (F32 CA89875-02, to B.J.Z.)
© 2004 American
Society for Clinical Oncology
Source:
http://www.jco.org/cgi/content/abstract/22/6/999?etoc
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