Comparison of psychosocial adaptation of advanced stage Hodgkin's disease and acute leukemia survivors. Cancer and Leukemia Group B.
BACKGROUND
The purpose of this study was to compare the long-term psychosocial adaptation of Hodgkin's disease and adult acute leukemia survivors.


METHODS
Two hundred seventy-three Hodgkin's disease (HD) and 206 adult acute leukemia (AL) survivors were interviewed by telephone concerning their psychosocial adjustment and problems they attributed to having been treated for cancer, using identical research procedures and a common set of instruments. The following measures were used: Psychosocial Adjustment to Illness Scale (PAIS); Brief Symptom Inventory (BSI); current Conditioned Nausea and Vomiting triggered by treatment-related stimuli (CNVI); Indices of Employment, Insurance and Sexual Problems Attributed to Cancer; Negative Socioeconomic Impact of Cancer Index (NSI). All participants had been treated on one of nine Hodgkin's disease or 13 acute leukemia Cancer and Leukemia Group B (CALGB) clinical trials from 1966-1988, and had been off treatment for one year or more (mean years: HD = 5.9; AL = 5.6).


RESULTS
HD survivors' risk of having a high distress score on the BSI was almost twice that found for AL survivors (odds ratio = 1.90), with 21% of HD vs. 14% of AL survivors (P < 0.05) having scores that were 1.5 standard deviations above the norm, suggestive of a possible psychiatric disorder. HD survivors reported greater fatigue (POMS Fatigue, P = 0.01; Vigor Subscales, P = 0.001), greater conditioned nausea (CNVI, P < 0.05), greater impact of cancer on their family life (PAIS Domestic Environment, P = 0.004) and poorer sexual functioning (PAIS Sexual Relationships, P = 0.0001), than AL survivors.


CONCLUSIONS
Treatment-related issues may have placed HD survivors at a greater risk for problems in long-term adaptation than AL survivors.
Kornblith
A B
AB
Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Herndon
J E
JE
Zuckerman
E
E
Cella
D F
DF
Cherin
E
E
Wolchok
S
S
Weiss
R B
RB
Diehl
L F
LF
Henderson
E
E
Cooper
M R
MR
Schiffer
C
C
Canellos
G P
GP
Mayer
R J
RJ
Silver
R T
RT
Schilling
A
A
Peterson
B A
BA
Greenberg
D
D
Holland
J C
JC
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D016009:Chi-Square Distribution; D002648:Child; D005260:Female; D006689:Hodgkin Disease / Q000401:mortality / Q000473:pathology / Q000523:psychology* / Q000628:therapy; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis / Q000401:mortality / Q000523:psychology* / Q000628:therapy; D011788:Quality of Life; D012042:Registries; D012720:Severity of Illness Index; D012737:Sex Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000209:etiology / Q000503:physiopathology; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*