title: Posttraumatic stress, depression and anxiety among adult long-term survivors of cancer in adolescence.
abstract: BACKGROUND
  To determine the prevalence of posttraumatic stress, depression and anxiety in adults who have survived cancer (5 years) diagnosed in adolescence, as compared to healthy controls.
  
  
  METHODS
  Survivors (n=820) of cancer during adolescence (age M=30.4+/-6.0 years; M=13.7+/-6.0 years since diagnosis) and 1027 matched controls without history of cancer (age M=31.5+/-6.9 years) completed standardised questionnaires measuring posttraumatic stress, depression and anxiety. Additionally, sub-groups of 202 survivors and 140 controls with elevated scores received structured interviews to ascertain DSM-IV-diagnoses.
  
  
  RESULTS
  A total of 22.4% of the survivors reported clinically relevant symptoms of posttraumatic stress, anxiety and/or depression compared to 14.0% of the controls (odds ratios [ORs] 1.77; 95% confidence interval [CI] 1.39-2.26). The odds of posttraumatic stress symptoms in male (OR 3.92, 95% CI 1.80-8.51) and female (OR 3.83, 95% CI 2.54-5.76) survivors were more than three times those in the controls. However, only female survivors reported symptoms of depression and anxiety significantly more often (respectively: OR 2.12, 95% CI 1.16-3.85; and OR 1.86, 95% CI 1.33-2.59) than the controls. A relevant subgroup of 24.3% of the survivors met DSM-IV criteria for at least one mental disorder compared to 15.3% of the controls.
  
  
  CONCLUSIONS
  Survivors of cancer during adolescence show an elevated risk of presenting symptoms of posttraumatic stress, anxiety and/or depression during adulthood which is also reflected in a greater number of DSM-IV diagnoses when compared to controls. Comprehensive follow-up assessments should include the examination of possible psychological late effects of a cancer diagnosis in adolescence in order to identify survivors needing psychosocial interventions even years after the completion of successful medical treatment.
authors.affiliation: University Ulm, Department of Child and Adolescent Psychiatry/Psychotherapy, Steinhövelstrasse 5, D-89075 Ulm, Germany. diana.seitz@uniklinik-ulm.de
authors.forename: Diana C M
authors.initials: DC
authors.lastname: Seitz
authors.forename: Tanja
authors.initials: T
authors.lastname: Besier
authors.forename: Klaus-Michael
authors.initials: KM
authors.lastname: Debatin
authors.forename: Desiree
authors.initials: D
authors.lastname: Grabow
authors.forename: Ute
authors.initials: U
authors.lastname: Dieluweit
authors.forename: Andreas
authors.initials: A
authors.lastname: Hinz
authors.forename: Peter
authors.initials: P
authors.lastname: Kaatsch
authors.forename: Lutz
authors.initials: L
authors.lastname: Goldbeck
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001008:Anxiety Disorders / Q000453:epidemiology*; D016022:Case-Control Studies; D003866:Depressive Disorder / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D015995:Prevalence; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult