Prevalence of anxiety, depression, and post-traumatic stress disorder among Omani children and adolescents diagnosed with cancer: a prospective cross-sectional study.
Adolescents
Anxiety
Cancer
Children
Depression
Oman
Post-traumatic stress disorder
Journal
BMC cancer
ISSN: 1471-2407
Titre abrégé: BMC Cancer
Pays: England
ID NLM: 100967800
Informations de publication
Date de publication:
23 Apr 2024
23 Apr 2024
Historique:
received:
23
01
2024
accepted:
16
04
2024
medline:
24
4
2024
pubmed:
24
4
2024
entrez:
23
4
2024
Statut:
epublish
Résumé
Children and adolescents diagnosed with cancer often experience psychological distress, encompassing anxiety, depression, and post-traumatic stress disorder (PTSD). This study aimed to evaluate the prevalence of these conditions among Omani children and adolescents diagnosed with cancer, alongside identifying contributing factors. A prospective cross-sectional study was conducted from October 2021 to June 2023 among a cohort of Omani children and adolescents (6-18 years old) diagnosed with cancer at three primary cancer referral centres in Oman. Validated Arabic-language versions of the Screen for Child Anxiety Related Disorders, the Center for Epidemiologic Studies Depression Scale for Children, and the Impact of Event Scale-Revised instruments were used to assess symptoms of anxiety, depression, and PTSD, respectively. An initial assessment (T1) was undertaken within the first 3 months of diagnosis, followed by a second assessment (T2) 3-6 months later. Of 113 eligible participants, 101 agreed to participate in the study (response rate: 95.6%), with 92 (91.0%) completing both assessments and included in the final analysis. Prevalence rates of anxiety, depression, and PTSD decreased from 43.5%, 56.5%, and 32.6%, respectively, at T1, to 38.0%, 35.9%, and 23.9% at T2. All average scores were below diagnostic cut-off points, except for the depression score at T1. Anxiety and depression scores decreased significantly (p = 0.043 and 0.001, respectively) between T1 and T2, as did the overall prevalence of depression (p = 0.004). At T1, linear regression analysis showed significant correlations between anxiety scores and the child's age and PTSD score (p < 0.05); these variables were also correlated with depression scores (p ≤ 0.001). At T2, significant correlations were observed between anxiety scores and the child's age and PTSD scores (p < 0.001). At both T1 and T2, anxiety, depression, and PTSD scores remained significantly correlated (p < 0.001). Omani children and adolescents recently diagnosed with cancer exhibit a high prevalence of anxiety, depression, and PTSD over time. Age-appropriate communication, ongoing support, and mental health services are recommended to help this patient group cope with their diagnosis and manage their emotional wellbeing. There is a need for future research to determine the effectiveness of specific psychological interventions in reducing the frequency of these disorders.
Sections du résumé
BACKGROUND
BACKGROUND
Children and adolescents diagnosed with cancer often experience psychological distress, encompassing anxiety, depression, and post-traumatic stress disorder (PTSD). This study aimed to evaluate the prevalence of these conditions among Omani children and adolescents diagnosed with cancer, alongside identifying contributing factors.
METHODS
METHODS
A prospective cross-sectional study was conducted from October 2021 to June 2023 among a cohort of Omani children and adolescents (6-18 years old) diagnosed with cancer at three primary cancer referral centres in Oman. Validated Arabic-language versions of the Screen for Child Anxiety Related Disorders, the Center for Epidemiologic Studies Depression Scale for Children, and the Impact of Event Scale-Revised instruments were used to assess symptoms of anxiety, depression, and PTSD, respectively. An initial assessment (T1) was undertaken within the first 3 months of diagnosis, followed by a second assessment (T2) 3-6 months later.
RESULTS
RESULTS
Of 113 eligible participants, 101 agreed to participate in the study (response rate: 95.6%), with 92 (91.0%) completing both assessments and included in the final analysis. Prevalence rates of anxiety, depression, and PTSD decreased from 43.5%, 56.5%, and 32.6%, respectively, at T1, to 38.0%, 35.9%, and 23.9% at T2. All average scores were below diagnostic cut-off points, except for the depression score at T1. Anxiety and depression scores decreased significantly (p = 0.043 and 0.001, respectively) between T1 and T2, as did the overall prevalence of depression (p = 0.004). At T1, linear regression analysis showed significant correlations between anxiety scores and the child's age and PTSD score (p < 0.05); these variables were also correlated with depression scores (p ≤ 0.001). At T2, significant correlations were observed between anxiety scores and the child's age and PTSD scores (p < 0.001). At both T1 and T2, anxiety, depression, and PTSD scores remained significantly correlated (p < 0.001).
CONCLUSIONS
CONCLUSIONS
Omani children and adolescents recently diagnosed with cancer exhibit a high prevalence of anxiety, depression, and PTSD over time. Age-appropriate communication, ongoing support, and mental health services are recommended to help this patient group cope with their diagnosis and manage their emotional wellbeing. There is a need for future research to determine the effectiveness of specific psychological interventions in reducing the frequency of these disorders.
Identifiants
pubmed: 38654218
doi: 10.1186/s12885-024-12272-z
pii: 10.1186/s12885-024-12272-z
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
518Informations de copyright
© 2024. The Author(s).
Références
Force LM, Abdollahpour I, Advani SM, Agius D, Ahmadian E, Alahdab F, et al. The global burden of childhood and adolescent cancer in 2017: an analysis of the global burden of disease study 2017. Lancet Oncol. 2019;20(9):1211–25. https://doi.org/10.1016/S1470-2045(19)30339-0
doi: 10.1016/S1470-2045(19)30339-0
Steliarova-Foucher E, Colombet M, Ries LAG, Moreno F, Dolya A, Bray F, et al. International incidence of childhood cancer, 2001-10: a population-based registry study. Lancet Oncol. 2017;18(6):719–31. https://doi.org/10.1016/S1470-2045(17)30186-9
doi: 10.1016/S1470-2045(17)30186-9
pubmed: 28410997
pmcid: 5461370
Lam CG, Howard SC, Bouffet E, Pritchard-Jones K. Science and health for all children with cancer. Science. 2019;363(6432):1182–6. https://doi.org/10.1126/science.aaw4892
doi: 10.1126/science.aaw4892
pubmed: 30872518
Zandki D, Sultan I. Pediatric oncology in the Arab world. 2021. In: Al-Shamsi HO, Abu-Gheida IH, Iqbal F, Al-Awadhi A, editors. Cancer in the Arab world. Singapore: Springer; 2022. pp. 409– 25. https://doi.org/10.1007/978-981-16-7945-2_26
National Center for Statistics and Information. Census of population, housing, and establishments. 2023. https://portal.ecensus.gov.om/ecen-portal/ . Accessed 14 Dec 2023.
Ministry of Health. Cancer incidence in Oman 2019 report. 2019. https://www.moh.gov.om/ar/web/general-directorate-of-primary-health-care/cancer-report . Accessed 14 Dec 2023.
Mehdi I, Al Farsi AA, Al Bahrani B, Al-Raisi SS. General oncology care in Oman. In: Al-Shamsi HO, Abu-Gheida IH, Iqbal F, Al-Awadhi A, editors. Cancer in the arab world. Singapore: Springer; 2022. pp. 175–93. https://doi.org/10.1007/978-981-16-7945-2_12
doi: 10.1007/978-981-16-7945-2_12
Al-Saadi LS, Chan MF, Al-Azri M. Prevalence of anxiety, depression, and post-traumatic stress disorder among children and adolescents with cancer: a systematic review and meta-analysis. J Pediatr Hematol Nurs. 2022;39(2):1140–31. https://doi.org/10.1177/27527530211056001
doi: 10.1177/27527530211056001
Rahmani A, Azadi A, Pakpour V, Faghani S, Afsari EA. Anxiety and depression: a cross-sectional survey among parents of children with cancer. Indian J Palliat Care. 2018;24(1):82–5. https://doi.org/10.4103/IJPC.IJPC_141_17
doi: 10.4103/IJPC.IJPC_141_17
pubmed: 29440813
pmcid: 5801636
Kazak AE, Alderfer M, Rourke MT, Simms S, Streisand R, Grossman JR. Posttraumatic stress disorder (PTSD) and posttraumatic stress symptoms (PTSS) in families of adolescent childhood cancer survivors. J Pediatr Psychol. 2004;29(3):211–9. https://doi.org/10.1093/jpepsy/jsh022
doi: 10.1093/jpepsy/jsh022
pubmed: 15131138
D’Urso A, Mastroyannopoulou K, Kirby A, Meiser-Stedman R. Posttraumatic stress symptoms in young people with cancer and their siblings: results from a UK sample. J Psychosoc Oncol. 2018;36(6):768–83. https://doi.org/10.1080/07347332.2018.1494664
doi: 10.1080/07347332.2018.1494664
pubmed: 30358521
van Warmerdam J, Zabih V, Kurdyak P, Sutradhar R, Nathan PC, Gupta S. Prevalence of anxiety, depression, and posttraumatic stress disorder in parents of children with cancer: a meta-analysis. Pediatr Blood Cancer. 2019;66(6):e27677. https://doi.org/10.1002/pbc.27677
doi: 10.1002/pbc.27677
pubmed: 30816008
McDonnell G, Baily C, Schuler T, Verdeli H. Anxiety among adolescent survivors of pediatric cancer: a missing link in the survivorship literature. Palliat Support Care. 2015;13(2):345–9. https://doi.org/10.1017/S1478951514000297
doi: 10.1017/S1478951514000297
pubmed: 24773913
Smith HR. Depression in cancer patients: pathogenesis, implications and treatment (review). Oncol Lett. 2015;9(4):1509–14. https://doi.org/10.3892/ol.2015.2944
doi: 10.3892/ol.2015.2944
pubmed: 25788991
pmcid: 4356432
Günay U, Sarman A, Salman U, Yılmaz AS. The effects of the activity of making jewelry from beads on the anxiety levels of children with cancer: a randomised controlled study. J Pediatr Hematol Oncol Nurs. 2022;39(5):317–25. https://doi.org/10.1177/27527530221068760
doi: 10.1177/27527530221068760
pubmed: 36129886
Hariz N, Bawab S, Atwi M, Tavitian L, Zeinoun P, Khani M, et al. Reliability and validity of the Arabic screen for child anxiety related emotional disorders (SCARED) in a clinical sample. Psychiatry Res. 2013;209(2):222–8. https://doi.org/10.1016/j.psychres.2012.12.002
doi: 10.1016/j.psychres.2012.12.002
pubmed: 23312477
Birmaher B, Brent DA, Chiappetta L, Bridge J, Monga S, Baugher M. Psychometric properties of the screen for child anxiety related Emotional disorders (SCARED): a replication study. J Am Acad Child Adolesc Psychiatry. 1999;38(10):1230–6. https://doi.org/10.1097/00004583-199910000-00011
doi: 10.1097/00004583-199910000-00011
pubmed: 10517055
Ayyash-Abdo HA, Nohra J, Okawa S, Sasagawa S. Depressive symptoms among adolescents in Lebanon: a confirmatory factor analytic study of the center for epidemiological studies depression for children. Acta Psychopathol. 2016;02(6):46. https://doi.org/10.4172/2469-6676.100072
doi: 10.4172/2469-6676.100072
Weissman MM, Orvaschel H, Padian N. Children’s symptoms and social functioning self-report scales: comparison of mothers’ and children’s reports. J Nerv Ment Dis. 1980;168(12):736–40. https://doi.org/10.1097/00005053-198012000-00005
doi: 10.1097/00005053-198012000-00005
pubmed: 7452212
Davey C, Heard R, Lennings C. Development of the Arabic versions of the impact of events scale-revised and the posttraumatic growth inventory to assess trauma and growth in Middle Eastern refugees in Australia. Clin Psychol. 2015;19(3):131–9. https://doi.org/10.1111/cp.12043
doi: 10.1111/cp.12043
Weiss DS. The impact of event scale-revised. In: Wilson JP, Tang CS, editors. Cross-cultural assessment of psychological trauma and PTSD. New York: Springer; 2007. pp. 219–38. https://doi.org/10.1097/01.naj.0000339101.39986.85
doi: 10.1097/01.naj.0000339101.39986.85
Sokol E, Desai AV. The evolution of risk classification for neuroblastoma. Child (Basel). 2019;6(2):27. https://doi.org/10.3390/children6020027
doi: 10.3390/children6020027
Al Balushi A. Psychosocial care needs of children with cancer and their families: perceptions and experiences of Omani oncologists and nurses. University of Maryland, Baltimore ProQuest Dissertations Publishing. 2019. https://www.proquest.com/openview/a2861f33f5ab326624a3e3fd249e1590/1?pq-origsite=gscholar&cbl=18750&diss=y . Accessed 22 Jan 2024.
Al-Adawi S. Mental health services in Oman: the need for more cultural relevance. Oman Med J. 2017;32(2):83–5. https://doi.org/10.5001/omj.2017.17
doi: 10.5001/omj.2017.17
pubmed: 28439377
pmcid: 5397090
El Khatib H, Alyafei A, Shaikh M. Understanding experiences of mental health help-seeking in arab populations around the world: a systematic review and narrative synthesis. BMC Psychiatry. 2023;23(1):324. https://doi.org/10.1186/s12888-023-04827-4
doi: 10.1186/s12888-023-04827-4
pubmed: 37161342
pmcid: 10170733
Lewandowska A, Zych B, Papp K, Zrubcová D, Kadučáková H, Šupínová M, et al. Problems, stressors and needs of children and adolescents with cancer. Child (Basel). 2021;8(12):1173. https://doi.org/10.3390/children8121173
doi: 10.3390/children8121173
Myers RM, Balsamo L, Lu X, Devidas M, Hunger SP, Carroll WL, et al. A prospective study of anxiety, depression, and behavioral changes in the first year after a diagnosis of childhood acute lymphoblastic leukemia: a report from the children’s oncology group. Cancer. 2014;120(9):1417–25. https://doi.org/10.1002/cncr.28578
doi: 10.1002/cncr.28578
pubmed: 24473774
Hockenberry MJ, Hooke MC, Rodgers C, Taylor O, Koerner KM, Mitby P, et al. Symptom trajectories in children receiving treatment for leukemia: a latent class growth analysis with multitrajectory modeling. J Pain Symptom Manage. 2017;54(1):1–8. https://doi.org/10.1016/j.jpainsymman.2017.03.002
doi: 10.1016/j.jpainsymman.2017.03.002
pubmed: 28433546
pmcid: 6431078
Dupuis LL, Lu X, Mitchell HR, Sung L, Devidas M, Mattano LA Jr, et al. Anxiety, pain, and nausea during the treatment of standard-risk childhood acute lymphoblastic leukemia: a prospective, longitudinal study from the children’s oncology group. Cancer. 2016;122(7):1116–25. https://doi.org/10.1002/cncr.29876
doi: 10.1002/cncr.29876
pubmed: 26773735
Kunin-Batson AS, Lu X, Balsamo L, Graber K, Devidas M, Hunger SP, et al. Prevalence and predictors of anxiety and depression after completion of chemotherapy for childhood acute lymphoblastic leukemia: a prospective longitudinal study. Cancer. 2016;122(10):1608–17. https://doi.org/10.1002/cncr.29946
doi: 10.1002/cncr.29946
pubmed: 27028090
Bin Lee ARY, Yau CE, Low CE, Li J, Ho RCM, Ho CSH. Severity and longitudinal course of depression, anxiety and post-traumatic stress in paediatric and young adult cancer patients: a systematic review and meta-analysis. J Clin Med. 2023;12(5):1784. https://doi.org/10.3390/jcm12051784
doi: 10.3390/jcm12051784
Al-Azri MH, Al-Awisi H, Al-Rasbi S, Al-Moundhri M. Coping with a diagnosis of breast cancer among Omani women. J Health Psychol. 2014;19(7):836–46. https://doi.org/10.1177/1359105313479813
doi: 10.1177/1359105313479813
pubmed: 23520353
Farhangi H, Badiei Z, Moharreri F. Prevalence of psychiatric symptoms in ALL patients during maintenance therapy. Iran J Pediatr Hematol Oncol. 2015;5(2):77–82.
Saluja G, Iachan R, Scheidt PC, Overpeck MD, Sun W, Giedd JN. Prevalence of and risk factors for depressive symptoms among young adolescents. Arch Pediatr Adolesc Med. 2004;158(8):760–5. https://doi.org/10.1001/archpedi.158.8.760
doi: 10.1001/archpedi.158.8.760
pubmed: 15289248
Akimana B, Abbo C, Balagadde-Kambugu J, Nakimuli-Mpungu E. Prevalence and factors associated with major depressive disorder in children and adolescents at the Uganda cancer institute. BMC Cancer. 2019;19(1):466. https://doi.org/10.1186/s12885-019-5635-z
doi: 10.1186/s12885-019-5635-z
pubmed: 31101016
pmcid: 6525350
Sisk BA, Fasciano K, Block SD, Mack JW. Impact of cancer on school, work, and financial independence among adolescents and young adults. Cancer. 2020;126(19):4400–6. https://doi.org/10.1002/cncr.33081
doi: 10.1002/cncr.33081
pubmed: 32658324
Donnan BM, Webster T, Wakefield CE, Dalla-Pozza L, Alvaro F, Lavoipierre J, et al. What about school? Educational challenges for children and adolescents with cancer. Educ Develop Psychol. 2015;32(1):23–40. https://doi.org/10.1017/edp.2015.9
doi: 10.1017/edp.2015.9
Wakefield CE, McLoone J, Goodenough B, Lenthen K, Cairns DR, Cohn RJ. The psychosocial impact of completing childhood cancer treatment: a systematic review of the literature. J Pediatr Psychol. 2010;35(3):262–74. https://doi.org/10.1093/jpepsy/jsp056
doi: 10.1093/jpepsy/jsp056
pubmed: 19578137
Harrison C. Canadian paediatric society. Treatment decisions regarding infants, children and adolescents. Paediatr Child Health. 2004;9(2):99–114. https://doi.org/10.1093/pch/9.2.99
doi: 10.1093/pch/9.2.99
Fainsilber Katz L, Fladeboe K, King K, Gurtovenko K, Kawamura J, Friedman D, et al. Trajectories of child and caregiver psychological adjustment in families of children with cancer. Health Psychol. 2018;37(8):725–35. https://doi.org/10.1037/hea0000619
doi: 10.1037/hea0000619
Unseld M, Krammer K, Lubowitzki S, Jachs M, Baumann L, Vyssoki B, et al. Screening for post-traumatic stress disorders in 1017 cancer patients and correlation with anxiety, depression, and distress. Psychooncology. 2019;28(12):2382–8. https://doi.org/10.1002/pon.5239
doi: 10.1002/pon.5239
pubmed: 31679172
pmcid: 6916606
Wang Y, Feng W. Cancer-related psychosocial challenges. Gen Psychiatr. 2022;35(5):e100871. https://doi.org/10.1136/gpsych-2022-100871
doi: 10.1136/gpsych-2022-100871
pubmed: 36311374
pmcid: 9540834
Al-Azri M, Al-Awisi H, Al-Rasbi S, El-Shafie K, Al-Hinai M, Al-Habsi H, et al. Psychosocial impact of breast cancer diagnosis among Omani women. Oman Med J. 2014;29(6):437–44. https://doi.org/10.5001/omj.2014.115
doi: 10.5001/omj.2014.115
pubmed: 25584162
pmcid: 4289498