PSYCHOLOGICAL AND PSYCHIATRIC IMPACT OF CANCER DIAGNOSIS AND MANAGEMENT ON CHILDREN (Study on Egyptian Pediatric Oncology Sample

Abstract

25 pediatric oncology patients selected from first time diagnosed and hospitalized cases in the inpatient pediatric oncology department and 25 pediatric oncology patients previously diagnosed and hospitalized more than once, (age range: 8-12 years), were studied. 56 % of patients met the criteria for an Axis I psychiatric diagnosis according to DSM IV : "Adjustment disorders" were present in 38% and "PTSD" in 16%. 34% presented symptoms not meeting DSM IV diagnostic criteria . 90 % of patients had an abnormal cancer-related distress. "Subsyndromal anxiety or depression" were found in 34 % of patients, 16 % presented "Reactive anxiety" , and 14 % had "Situational anxiety". Newly diagnosed children perceived more frequently and intensively cancer­ related stressors, specially painful procedures, while previously diagnosed children were better adjusted to these stressors. For 76% of patients, the Total score of BriefPsychiatric Rating Scale for Children (BPRS-C) was in the "mild pathological score" range, and 66% of patients had moderate anxiety. Newly diagnosed children had a worse quality of life (QOL), as regards Total functioning, Psychosocial functioning , Physical functioning, Treatment anxiety, Pain and Procedural anxiety . Previously diagnosed children had a worse QOL as regards Perceived physical appearance. The majority of patients perceived hospital-related stressors as the "worst possible", and their coping with hospital-related stressors as the "best possible". The most frequently reported stress categories of stressful events during hospitalization, were intrusive events (50% of all responses). Social and Spiritual support, were the most frequently used coping strategies, while Behavioral avoidance was more used by newly diagnosed patients. In working caretakers, concentration and daily routine were greatly affected by the child's illness.