title: Posttraumatic stress symptoms in adult survivors of childhood cancer.
abstract: BACKGROUND
  Previous research suggests that posttraumatic stress disorder (PTSD) is present in survivors of childhood cancer. The aim of the current study was to explore posttraumatic stress symptoms in a sample of young adult survivors of childhood cancer. In addition, the impact of demographic, medical and treatment factors on survivors' posttraumatic stress symptoms was studied.
  
  
  METHODS
  Participants were 500 long-term survivors of childhood cancer. The median age at follow-up was 24 years (age range, 16- 49 years, 47% female). To assess symptoms of posttraumatic stress, all participants completed the Impact of Event Scale (IES), a self-report instrument consisting of two subscales, intrusion and avoidance.
  
  
  RESULTS
  Twelve percent of this sample of adult survivors of childhood cancer had scores in the severe range, indicating they are unable to cope with the impact of their disease and need professional help. Twenty percent of the female survivors had scores in the severe range as compared with 6% of the male survivors. Linear regression models revealed that being female, unemployed, a lower educational level, type of diagnosis and severe late effects/health problems were associated with posttraumatic stress symptoms.
  
  
  CONCLUSIONS
  The results indicate that, although the proportion of survivors reporting symptoms is well within the proportions found in the general population, a substantial subset of survivors report symptoms of posttraumatic stress. This finding supports the outcomes reported previously that diagnosis and treatment for childhood cancer may have significant long-term effects, which are manifested in symptoms of posttraumatic stress. The investigated factors could explain posttraumatic stress symptoms only to a limited extent. Further research exploring symptoms of posttraumatic stress in childhood cancer survivors in more detail is clearly warranted. From a clinical perspective, health care providers must pay attention to these symptoms during evaluations in the follow-up clinic. Early identification and treatment of PTSD symptoms can enhance the quality of life for survivors of childhood cancer.
authors.affiliation: Department of Paediatric Oncology (From the Late Effects Study Group), Emma Kinderziekenhuis, Academic Medical Center, University of Amsterdam, The Netherlands. n.e.langeveld@amc.uva.nl
authors.forename: N E
authors.initials: NE
authors.lastname: Langeveld
authors.forename: M A
authors.initials: MA
authors.lastname: Grootenhuis
authors.forename: P A
authors.initials: PA
authors.lastname: Voûte
authors.forename: R J
authors.initials: RJ
authors.lastname: de Haan
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D004522:Educational Status; D004651:Employment; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000523:psychology*; D012307:Risk Factors; D012737:Sex Factors; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology*