Trajectories and risk factors for anxiety and depression in children and adolescents with cancer: A 1-year follow-up

Maya Yardeni, Gadi Abebe Campino, Ilanit Hasson-Ohayon, Dana Basel, Nimrod Hertz-Palmor, Shira Bursztyn, Hana Weisman, Itai M Pessach, Amos Toren, Doron Gothelf, Maya Yardeni, Gadi Abebe Campino, Ilanit Hasson-Ohayon, Dana Basel, Nimrod Hertz-Palmor, Shira Bursztyn, Hana Weisman, Itai M Pessach, Amos Toren, Doron Gothelf

Abstract

Background: There is limited data on the longitudinal trajectories of psychiatric disorders in children with cancer and risk factors for their persistence. The current study aimed to longitudinally assess the trajectories and risk factors for anxiety and depressive symptoms and disorders in children and adolescents with cancer.

Methods: Children and adolescents with cancer and their parents completed the Patient-Reported Outcomes Measurement Information System (PROMIS) Depression and Anxiety Module and were interviewed by the semi-structured Affective and Anxiety Modules of the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS), at 4 time points, 1, 4, 7, and 12 months following the diagnosis of cancer.

Results: Of the 99 patients enrolled, 48% met criteria for anxiety and/or depressive disorders at least once during the follow-up period. There was a significant decrease in PROMIS pediatric and parent anxiety and depression scores (all p's < 0.01) and in the rate of depressive disorders over time (p = 0.02), while rates of anxiety disorders remained stable. Anxiety PROMIS pediatric and parent scores at baseline, having brain tumors and being in the acute treatment phase significantly predicted the presences of anxiety disorders at endpoint.

Conclusions: Our results highlight the importance of screening for anxiety and disorders in children with cancer, especially among those with brain tumors and at the acute phase of treatment.

Keywords: PROMIS; anxiety; cancer; depression; longitudinal; risk-factors.

Conflict of interest statement

The authors have no conflict of interest to declare.

© 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Figures

FIGURE 1
FIGURE 1
Flowchart of patients recruitment and assessment presenting the number of patients assessed at each time point and the number of dropouts. Of note, 5 patients enrolled to the study at Time 2. Due to medical travel or no‐shows some patients were not available at certain time‐points: at Time 2 (n = 11), at Time 3 (n = 15) and at Time 4 (n = 4)
FIGURE 2
FIGURE 2
Changes in PROMIS anxiety and depression scores overtime based on (A) child report (B) parent report. Error bars represent standard errors. Planned contrasts indicated that on anxiety child report T1>T3 (p < 0.006); on anxiety parent report T1 > T2 (p < 0.039) and T3 > T4 (p < 0.0001) and on depression child report T1 > T3 (p < 0.002) and on depression parent report T1 > T4 (p < 0.002)
FIGURE 3
FIGURE 3
Change in rates of any anxiety and depressive disorders along time. Error bars represent 95% confidence interval. P‐values are derived from Friedman's χ2 test

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