title: Psychological outcomes of siblings of cancer survivors: a report from the Childhood Cancer Survivor Study.
abstract: OBJECTIVE
  To identify risk factors for adverse psychological outcomes among adult siblings of long-term survivors of childhood cancer.
  
  
  METHODS
  Cross-sectional, self-report data from 3083 adult siblings (mean age 29 years, range 18-56 years) of 5 + year survivors of childhood cancer were analyzed to assess psychological outcomes as measured by the Brief Symptom Inventory-18 (BSI-18). Sociodemographic and health data, reported by both the siblings and their matched cancer survivors, were explored as risk factors for adverse sibling psychological outcomes through multivariable logistic regression.
  
  
  RESULTS
  Self-reported symptoms of psychological distress, as measured by the global severity index of the BSI-18, were reported by 3.8% of the sibling sample. Less than 1.5% of siblings reported elevated scores on two or more of the subscales of the BSI-18. Risk factors for sibling depression included having a survivor brother (OR 2.22, 95% CI 1.42-3.55), and having a survivor with impaired general health (OR 2.15, 95% CI 1.18-3.78). Siblings who were younger than the survivor reported increased global psychological distress (OR 1.81, 95% CI 1.05-3.12), as did siblings of survivors reporting global psychological distress (OR 2.32, 95% CI 1.08-4.59). Siblings of sarcoma survivors reported more somatization than did siblings of leukemia survivors (OR 2.07, 95% CI 1.05-3.98).
  
  
  CONCLUSIONS
  These findings suggest that siblings of long-term childhood cancer survivors are psychologically healthy in general. There are, however, small subgroups of siblings at risk for long-term psychological impairment who may benefit from preventive risk-reduction strategies during childhood while their sibling with cancer is undergoing treatment.
authors: Department of Pediatrics and Division of Hematology, CHOC Children's Hospital, Orange, CA 92868, USA. dbuchbinder@choc.org
authors: David
authors: D
authors: Buchbinder
authors: Jacqueline
authors: J
authors: Casillas
authors: Kevin R
authors: KR
authors: Krull
authors: Pam
authors: P
authors: Goodman
authors: Wendy
authors: W
authors: Leisenring
authors: Christopher
authors: C
authors: Recklitis
authors: Melissa A
authors: MA
authors: Alderfer
authors: Leslie L
authors: LL
authors: Robison
authors: Gregory T
authors: GT
authors: Armstrong
authors: Alicia
authors: A
authors: Kunin-Batson
authors: Margaret
authors: M
authors: Stuber
authors: Lonnie K
authors: LK
authors: Zeltzer
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology; D005260:Female; D006801:Humans; D007938:Leukemia / Q000523:psychology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012509:Sarcoma / Q000523:psychology; D012720:Severity of Illness Index; D035781:Siblings / Q000523:psychology*; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000209:etiology; D017741:Survivors / Q000523:psychology*; D055815:Young Adult