Posttraumatic stress symptoms after childhood cancer.

The posttraumatic stress model has recently been applied to understand the impact of life-threatening illness in adults and in children. From 1991 to 2001, 20 studies have reported posttraumatic stress symptoms and/or posttraumatic stress disorder (PTSD) in childhood cancer survivors and/or their parents. A review of these studies is proposed. Prevalence of posttraumatic stress symptoms and/or PTSD in children and in their parents has been estimated, across studies, between 2 and 20 % in survivors and between 10 and 30 % in their parents, even many years after the end of cancer treatment. Time elapsed since the diagnosis of cancer is usually not predictive of persistent symptoms. Subjective appraisal of life threat and illness beliefs are more important predictors than objective medical data. The presence of symptoms in survivors is not always related to that in their parents. The posttraumatic stress model renews the approach and understanding of psychopathological reactions of children with cancer, regarding trauma features and the role of parental responses. This model has important implications for individual and family clinical interventions. A reflection on the disruption of family functioning by childhood cancer (an example being bone marrow transplantation with a related donor) and on the recovery processes is needed.