Prevalence and predictors of posttraumatic stress disorder in adult survivors of childhood cancer.
Prevalence and predictors of posttraumatic stress disorder in adult survivors of childhood cancer.
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DOI：
10.1542/peds.2009-2308
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发表时间：
2010-05
期刊：
影响因子：
8
通讯作者：
Zeltzer LK
中科院分区：
文献类型：
--
作者：
Stuber ML;Meeske KA;Krull KR;Leisenring W;Stratton K;Kazak AE;Huber M;Zebrack B;Uijtdehaage SH;Mertens AC;Robison LL;Zeltzer LK
最近的研究发现，一小部分儿童癌症的年轻成年幸存者报告了他们的诊断和治疗后的创伤后应激症状。然而，目前尚不清楚这些症状是否与日常功能障碍和/或严重痛苦相关，从而导致临床障碍。此外，尚不清楚这种疾病是否会持续到非常长期的生存期，包括生命的第三和第四十年。这项研究假设，与一组健康的兄弟姐妹相比，儿童癌症的长期幸存者更有可能报告创伤后应激障碍的症状，伴有功能障碍和/或临床痛苦。1970年至1986年期间确诊的6,542名18岁以上的儿童癌症幸存者和368名癌症幸存者的兄弟姐妹完成了一项全面的人口和健康调查。589名幸存者（9%）和8名兄弟姐妹（2%）除了与创伤后应激障碍（PTSD）完全诊断一致的一系列症状外，还报告了功能障碍和/或临床困扰。与兄弟姐妹相比，幸存者患PTSD的风险超过4倍（OR=4.14, 95%CI: 2.08-8.25）。控制人口统计学和治疗变量后，PTSD风险增加与高中以下教育水平（or =1.51, 95% CI=1.16-1.98）、未婚（or =1.99, 95% CI=1.58-2.50）、年收入低于20,000美元（or =1.63, 95% CI=1.21-2.20）和失业（or =2.01, 95% CI=1.62-2.51）相关。强化治疗也与完全PTSD的风险增加相关（OR=1.36, 95% CI 1.06 -1.74）。儿童癌症幸存者患创伤后应激障碍的几率明显高于兄弟姐妹。虽然大多数幸存者表现良好，但有一小部分人报告了严重的损伤，可能需要有针对性的干预。
Recent studies have found that a subset of young adult survivors of childhood cancer report posttraumatic stress symptoms in response to their diagnosis and treatment. However, it is unclear if these symptoms are associated with impairment in daily functions and/or significant distress, thereby resulting in a clinical disorder. Furthermore, it is unknown whether this disorder continues into very long-term survivorship, including the 3rd and 4th decades of life. This study hypothesized that very long-term survivors of childhood cancer would be more likely to report symptoms of posttraumatic stress disorder, with functional impairment and/or clinical distress, compared to a group of healthy siblings. 6,542 childhood cancer survivors over the age of 18 who were diagnosed between 1970 and 1986 and 368 siblings of cancer survivors completed a comprehensive demographic and health survey. 589 survivors (9%) and 8 siblings (2%) reported functional impairment and/or clinical distress in addition to the set of symptoms consistent with a full diagnosis of Posttraumatic Stress Disorder (PTSD). Survivors had more than a four-fold risk of PTSD compared to siblings (OR=4.14, 95%CI: 2.08-8.25). Controlling for demographic and treatment variables, increased risk of PTSD was associated with educational level of high school or less (OR=1.51, 95% CI=1.16-1.98), being unmarried (OR=1.99, 95% CI=1.58-2.50), annual income less than $20,000 (OR=1.63, 95% CI=1.21-2.20), and being unemployed (OR=2.01, 95% CI=1.62-2.51). Intensive treatment was also associated with increased risk of full PTSD (OR=1.36, 95% CI 1.06 -1.74). Posttraumatic stress disorder is reported significantly more often by childhood cancer survivors than by sibling controls. Although most survivors are apparently doing well, a subset report significant impairment that may warrant targeted intervention.
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影响因子：
6.7
作者：
Steinberg, Alan M;Brymer, Melissa J;Pynoos, Robert S
通讯作者：
Pynoos, Robert S
影响因子：
3
作者：
MCHORNEY, CA;WARE, JE;RACZEK, AE
通讯作者：
RACZEK, AE
影响因子：
3.6
作者：
Gerhardt, Cynthia A.;Yopp, Justin M.;Noll, Robert B.
通讯作者：
Noll, Robert B.
影响因子：
45.3
作者：
Hobbie, WL;Stuber, M;Kazak, AE
通讯作者：
Kazak, AE
DOI：
10.1002/mpo.1316
发表时间：
2002-04-01
期刊：
MEDICAL AND PEDIATRIC ONCOLOGY
影响因子：
--
作者：
Robison, LL;Mertens, AC;Zeltzer, LK
通讯作者：
Zeltzer, LK