Psychiatric disorders in 130 survivors of childhood cancer: preliminary results of a semi-standardized interview.

BACKGROUND: Although psychological sequelae are well known among survivors of childhood cancer, psychiatric sequelae remain inadequately explored. Long-term psychiatric sequelae and their main risk factors in this population were evaluated. PROCEDURE: Initially, 483 survivors of childhood cancer, except leukemia, were invited to complete a questionnaire assessing their health and quality of life. Of them, 130 completed the survey, subsequently consulted with a pediatric oncologist and an internist, and met with a psychologist for a semi-standardized interview based on the Mini International Neuropsychiatric Interview (MINI), which allowed diagnosis of DSM-IV Axis 1 psychiatric disorders. The collected data were compared with those of the French general population.
RESULTS: Seventy-three of the 130 survivors (56.2%) who completed the MINI interview reported experiencing at least one psychiatric disorder since cancer diagnosis, mostly anxiety (39.2%), mood (27.7%), or major depressive (24.6%) disorders; 46 reported at least one current disorder (35.4%). Agoraphobia (P = 0.02) and psychotic disorders were more common (P = 0.003) and general anxiety disorder less common (P < 0.001) among survivors than the general population. Most disorders correlated significantly with survivors' ratings of lower quality of life. Smoking, cancer type, and treatments significantly influenced the prevalence of psychiatric disorders.
CONCLUSIONS: Results were consistent between the self-questionnaire and MINI interview responses, though time may have biased memory. Vulnerability to and high risk for developing DSM-IV Axis 1 psychiatric disorders of childhood cancer survivors can persist long after diagnosis and treatment. Thus, systematic and general psychological screening of survivors may facilitate long-term psychological restoration.