Psychologic distress amongst adolescent and young adult cancer survivors’ and parents.

Abstract

10056 Background: Increasing survival in adolescent and young adult (AYA) cancer patients has led to a growing population at risk for poor psychological outcomes. We sought to identify risk factors for the development of psychologic distress and post-traumatic stress (PTS) in AYA survivors and their parents. Methods: In a single-institution prospective cohort study, survivors ages 10-25 years old completed a self-report review of systems (ROS) and psychosocial surveys at initial and follow up visits, including the Youth (YSR) or Adult Self Report (ASR) assessing psychologic distress and the Impact of Events Scale (IES) assessing PTS. Parents of patients ages 10-18 years completed the Childhood Behavior Checklist (CBCL) assessing their child’s psychologic distress. Parents completed the Beck Anxiety (BAI) and Depression (BDI) Index and IES assessing their personal anxiety, depression, and PTS. Psychologic distress and PTS were defined dichotomously with an internalizing problems T-score ≥ 60 on YSR/ASR/CBCL and IES ≥ 24, respectively. Psychologic distress and PTS were further analyzed as continuous variables in multivariable linear regression models with age, diagnosis, gender, time from end of therapy (EOT), substance use, sexual dysfunction, ROS, and therapy intensity. Spearman correlation coefficients were computed to assess relationships between patient and parent scores. Results: The study enrolled 135 patients and 72 parents, of which 37 were parents of 10-18-year-olds. Median age of patients at diagnosis was 15 years and median time from EOT was 3.2 years. 50% were female, 65% had a hematologic malignancy, and 92% were white. 20% of patients reported psychologic distress. 17% of patients and 17% of parents reported PTS. 10% and 13% of parents reported at least moderate anxiety and depression, respectively. In multivariable regression analyses, psychologic distress was associated with a higher number of patient-reported systems (Slope estimate = 2.98, p < 0.01) and shorter time since EOT (-0.45, p = 0.03). PTS was associated with a higher number of patient-reported system (1.46-fold, p < 0.01). Multivariable regression analyses in parent data showed parent-reported psychologic distress of patient was associated with a higher number of patient-reported systems (6.01, p = 0.03). Positive correlations were seen between parent-reported psychologic distress of patient and patient self-reported psychologic distress (R = 0.58, p < 0.01) and also with patient self-reported PTS (R = 0.51, p < 0.01). Parent reported psychologic distress of patient was positively correlated with parent self-reported anxiety (R = 0.45, p = 0.01) and also with parent self-reported PTS (R = 0.42, p = 0.02). Conclusions: A meaningful minority of survivors and parents face psychologic distress and PTS. A larger study is ongoing to expand upon our preliminary findings and examine the trajectory of psychologic distress and PTS in survivorship.