Jacqui van Warmerdam1, Rinku Sutradhar2,3, Paul Kurdyak3,4, Cindy Lau2, Jason D Pole2,3,5, Paul C Nathan1,2,6, Sumit Gupta1,2,6. 1. The Hospital for Sick Children, Toronto, Ontario, Canada. 2. ICES, Toronto, Ontario, Canada. 3. Dalla Lana School of Public Health, University of Toronto, Ontario, Canada. 4. Centre for Addiction and Mental Health, Toronto, Ontario, Canada. 5. Pediatric Oncology Group of Ontario, Toronto, Ontario, Canada. 6. Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada.
Abstract
PURPOSE: Although a diagnosis of childhood cancer can have a profound effect on the entire family unit, its impact on the long-term mental health of family members is not well characterized. METHODS: A provincial childhood cancer registry in Ontario, Canada, was linked to birth records to identify separate population-based cohorts of mothers and siblings of children diagnosed with cancer between 1998 and 2014. The mother and sibling cohorts were matched to corresponding population controls and linked to health services data. The rate of mental health-related outpatient visits (family physician, psychiatrist) and the incidence of severe psychiatric events (psychiatric emergency department visit, psychiatric hospitalization, suicide) were compared between mothers and siblings and their controls. Possible predictors of mental health outcomes were examined, including demographics, characteristics of the cancer-affected child, and cancer treatment. RESULTS: We identified 4,773 mothers and 7,897 siblings of children diagnosed with cancer during the study period. Compared with controls, both groups experienced elevated rates of outpatient visits (mothers: rate ratio [RR], 1.4; P < .0001; siblings: RR, 1.1; P < .0001). The risk of severe psychiatric events was not increased in either cohort. Mother and sibling demographic factors associated with increased risk of adverse mental health included younger maternal age at cancer diagnosis, low socioeconomic status, and rural residence among mothers and older sibling age among siblings. Treatment-related variables pertaining to the cancer-affected child were not associated with mental health outcomes. Mental health outcomes clustered within families. CONCLUSION: Both mothers and siblings experience elevated and prolonged need for mental health-related health care as compared with the general population. Demographic risk factors predict subpopulations at highest risk. Increased psychosocial support for family members during and after cancer therapy is warranted.
PURPOSE: Although a diagnosis of childhood cancer can have a profound effect on the entire family unit, its impact on the long-term mental health of family members is not well characterized. METHODS: A provincial childhood cancer registry in Ontario, Canada, was linked to birth records to identify separate population-based cohorts of mothers and siblings of children diagnosed with cancer between 1998 and 2014. The mother and sibling cohorts were matched to corresponding population controls and linked to health services data. The rate of mental health-related outpatient visits (family physician, psychiatrist) and the incidence of severe psychiatric events (psychiatric emergency department visit, psychiatric hospitalization, suicide) were compared between mothers and siblings and their controls. Possible predictors of mental health outcomes were examined, including demographics, characteristics of the cancer-affected child, and cancer treatment. RESULTS: We identified 4,773 mothers and 7,897 siblings of children diagnosed with cancer during the study period. Compared with controls, both groups experienced elevated rates of outpatient visits (mothers: rate ratio [RR], 1.4; P < .0001; siblings: RR, 1.1; P < .0001). The risk of severe psychiatric events was not increased in either cohort. Mother and sibling demographic factors associated with increased risk of adverse mental health included younger maternal age at cancer diagnosis, low socioeconomic status, and rural residence among mothers and older sibling age among siblings. Treatment-related variables pertaining to the cancer-affected child were not associated with mental health outcomes. Mental health outcomes clustered within families. CONCLUSION: Both mothers and siblings experience elevated and prolonged need for mental health-related health care as compared with the general population. Demographic risk factors predict subpopulations at highest risk. Increased psychosocial support for family members during and after cancer therapy is warranted.
Authors: Keun Hye Jeon; In Young Choi; In Young Cho; Dong Wook Shin; Ji Won Lee; Hee Jo Baek; Nack-Gyun Chung; Ki Woong Sung; Yun-Mi Song Journal: J Cancer Surviv Date: 2021-11-06 Impact factor: 4.062
Authors: Julia Baenziger; Katharina Roser; Luzius Mader; Erika Harju; Marc Ansari; Nicolas Waespe; Katrin Scheinemann; Gisela Michel Journal: J Psychosoc Oncol Res Pract Date: 2020-07-28
Authors: Carolyn R Bates; Diane Fairclough; Robert B Noll; Maru E Barrera; Mary Jo Kupst; Anna M Egan; Maria A Gartstein; Emily L Ach; Cynthia A Gerhardt; Kathryn Vannatta Journal: Pediatr Blood Cancer Date: 2022-01-19 Impact factor: 3.167
Authors: Michael J Raphael; Rebecca Griffiths; Yingwei Peng; Sumit Gupta; D Robert Siemens; Claudio Soares; Christopher M Booth Journal: J Natl Cancer Inst Date: 2021-09-04 Impact factor: 13.506