title: Persistent psychological distress in long-term survivors of pediatric sarcoma: the experience at a single institution.
abstract: BACKGROUND
  The long-term psychological impact of pediatric sarcoma is largely unknown. As part of a cross-sectional study examining the late effects of pediatric sarcoma therapy, we examined whether psychological distress or posttraumatic stress symptoms are present in an adult cohort of pediatric sarcoma survivors.
  
  
  METHODS
  Thirty-four patients participated in the study, an average of 17 years after their treatment ended, each completing the SCID module for Posttraumatic Stress Disorder, Impact of Events Scale, Brief Symptom Inventory (BSI) and a questionnaire assessing sociodemographic variables and psychosocial issues.
  
  
  RESULTS
  Significant persistent psychological distress characterized this cohort of patients. Seventy-seven percent scored in the clinical range on the BSI. Twelve percent met diagnostic criteria for PTSD. Current psychological distress was associated with intrusive thoughts and avoidant behaviors, male gender, employment, difficulty readjusting to work/school after treatment, and enduring worries about health. No differences were found based on age, presence of metastatic disease or time since diagnosis.
  
  
  CONCLUSIONS
  This is the first report of a clinical evaluation of psychological distress in a cohort of pediatric sarcoma survivors treated with intensive multimodal cancer therapy. The results suggest that survivors of pediatric sarcoma might be at high risk for adverse psychological outcomes. Appropriate interventions are proposed.
authors.affiliation: Pediatric Oncology Branch, National Cancer Institute, Center for Cancer Research, National Institutes of Health, USA. wienerl@mail.nih.gov
authors.forename: Lori
authors.initials: L
authors.lastname: Wiener
authors.forename: Haven
authors.initials: H
authors.lastname: Battles
authors.forename: Donna
authors.initials: D
authors.lastname: Bernstein
authors.forename: Lauren
authors.initials: L
authors.lastname: Long
authors.forename: Joanne
authors.initials: J
authors.lastname: Derdak
authors.forename: Crystal L
authors.initials: CL
authors.lastname: Mackall
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Mansky
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D015331:Cohort Studies; D003131:Combined Modality Therapy / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D015995:Prevalence; D012509:Sarcoma / Q000523:psychology* / Q000628:therapy*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000209:etiology*; D017741:Survivors / Q000523:psychology*; D014481:United States / Q000453:epidemiology