Posttraumatic stress disorders in long-term Egyptian survivors after childhood cancer

Abstract

Middle East Current Psychiatry 2012, 19:40–47 Background Seventy-five percent of children who are diagnosed with cancer are expected to survive. As this population has grown, the study of the impact of this traumatic event has become increasingly important. Objectives The current study aimed to investigate the prevalence and risk factors of posttraumatic stress disorder (PTSD) and posttraumatic stress symptoms (PTSS) in long-term childhood cancer survivors. Methods Eighty survivors of childhood cancer who were between 9 and 17 years of age (mean ± SD = 12.9 ± 2.28), had stopped therapy for at least 2 years, had no history of previous central nervous system relapse or cranial irradiation, and did not have premorbid medical diseases, were enrolled in the study. They were assessed in terms of PTSD, PTSS, and Children’s Global Assessment Scale. They were compared with age-matched and sex-matched healthy controls. Results Fourteen survivors (17.5%) met the criteria of lifetime diagnosis of PTSD according to Kiddie-Sads-Present and Lifetime Version diagnostic and clinical versus 5% of the control group (v = 6.26, P = 0.04, odds ratio = 4.03, confidence interval = 1.26–12.84). In the survivor group, current PTSS were severe in 10%; moderate in 32.5%; and mild in 50%, according to the children posttraumatic stress disorder reaction index. None of the children in the control group had severe PTSS. Severe PTSS are associated with older age at diagnosis, older age during study, relapse, increased duration of therapy, and use of chemotherapy plus irradiation and/or surgery. Severe PTSS are associated with lower scores on Children’s Global Assessment Scale. Conclusion Both PTSD and PTSS may be prevalent in cancer survivors even after a complete physical cure. Adequate treatment of traumatic memories, arousal and avoidance, may improve social and psychological functioning, and quality of life. This will lead to better orientation toward health services.