Depression and anxiety (DA) in children within one year of a cancer diagnosis.

Abstract

10064 Background: While 10% of children were treated with anti-depressants within 1 year of a cancer diagnosis in a previous study, neither the prevalence nor time course of DA were studied. The American Association of Pediatrics advocates for the use of screening for DA, yet data are lacking regarding timing, frequency, or predictive success of screening in children concurrently receiving therapy for cancer. Methods: We evaluated 87 prospectively diagnosed children at a single institution for DA at 5 time points during the first year of a cancer diagnosis. 55 children completed all screening, 70 missed at most one visit. Starting within 1 month of cancer diagnosis, patients completed the Childhood Depression Inventory (CDI) and the Speilberger State/Trait Anxiety Inventory (STAI) and again at 3, 6, 9, and 12 months. Those patients who scored ≥ 11 on the CDI or ≥ one standard deviation above the mean for age on the STAI were referred for psychiatric consultation the same day. Results: Overall 33 patients (39%) indicated symptoms suggestive of either depression or anxiety during their first year of cancer therapy; n=29 (35%) depression, n=17 (20%) state and n=10 (12%) trait anxiety. Fifty-six consultations resulted in 33 psychiatry diagnoses confirmed in 21 patients (23 depression, 3 anxiety and 7 other). Half of the patients received a diagnosis of DA at least twice over the course of the study, suggesting persistent, significant symptoms. Conclusions: We conclude that screening for DA is effective in children with cancer and that prevalence for symptoms is high. The highest risk for symptoms of DA is within 1 month of diagnosis but during the 1st year of therapy children continue to suffer symptoms of DA highlighting the importance of continued screening. [Table: see text]