title: Suicide ideation in pediatric and adult survivors of childhood brain tumors.
abstract: Survivors of pediatric brain tumors are at risk for long-term psychological morbidities. The current study investigated the prevalence and predictors of suicide ideation (SI) in a clinical sample of youth and adult survivors. Retrospective chart reviews were completed for 319 survivors of pediatric brain tumors who were assessed via clinical interview during routine neuro-oncology clinic visits between 2003 and 2007. Survivors were, on average, 18.0 years of age (SD = 4.9) and 10 years from diagnosis (SD = 5.0) at their most recent follow-up. The most common diagnosis was low-grade glioma (n = 162) followed by embryonal tumors (PNET/medulloblastoma; n = 64). Multivariable logistic regression was used to calculate odds ratios (OR) and 95 % confidence intervals (CI) for SI. Nearly 12 % of survivors (11.7 %, n = 37) reported SI. Five survivors (1.5 %) had documented suicide attempts, though none were fatal. In a multivariable model, adjusting for sex and age, history of depression (OR = 20.6, 95 % CI = 4.2-101.1), psychoactive medication treatment (OR = 4.5, 95 % CI = 1.8-11.2), observation or surgery only treatment (OR = 3.7, 95 % CI = 1.5-9.1), and seizures (OR = 3.6, 95 % CI = 1.1-11.1) were significantly associated with SI in survivors. Survivors of pediatric brain tumors appear to be at risk for experiencing SI. Our results underscore the importance of a multidisciplinary approach to providing follow-up care for childhood brain tumor survivors, including routine psychological screenings.
authors.affiliation: Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215, USA. tara.brinkman@stjude.org
authors.forename: Tara M
authors.initials: TM
authors.lastname: Brinkman
authors.forename: Cori C
authors.initials: CC
authors.lastname: Liptak
authors.forename: Brian L
authors.initials: BL
authors.lastname: Delaney
authors.forename: Christine A
authors.initials: CA
authors.lastname: Chordas
authors.forename: Anna C
authors.initials: AC
authors.lastname: Muriel
authors.forename: Peter E
authors.initials: PE
authors.lastname: Manley
mesh_terms: D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000150:complications / Q000401:mortality / Q000523:psychology*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000150:complications / Q000401:mortality / Q000523:psychology*; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000150:complications / Q000401:mortality / Q000523:psychology*; D009483:Neuropsychological Tests; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D013315:Stress, Psychological / Q000209:etiology*; D059020:Suicidal Ideation; D015996:Survival Rate; D017741:Survivors / Q000523:psychology*; D055815:Young Adult