Psychiatric disorders in adolescent cancer survivors: A systematic review of prevalence and predictors

Abstract

Background: Adolescent cancer survivors are a particularly vulnerable group of young patients. Compared with healthy peers, adolescent survivors face more psychosocial difficulties and are at increased risk of developing psychiatric disorders. Aims: We aimed to establish prevalence rates and predictors of psychiatric disorders in young cancer survivors and discuss areas for targeted interventions. Method: We systematically reviewed four major online databases: Embase, PsychINFO, Scopus, and Medline for quantitative studies evaluating mental health in adolescent cancer survivors. We used a narrative synthesis approach. Results: Nineteen studies met our inclusion criteria. Across the sample, up to 34% met criteria for post-traumatic stress disorder (PTSD), 13% for clinical depression, and 8% for anxiety. Maladaptive coping, illness relapse, higher number of late effects, brain tumor diagnosis, and poor family functioning and parental distress were associated with higher psychological distress. Conclusions: A significant subset of adolescent survivors reports PTSD, anxiety, and depression symptoms. Individuals who present with more vulnerabilities and higher risk indices should be routinely assessed in order to reduce the psychological, social, and economic burden associated with poor mental health in this population. Early prevention strategies should target maladaptive coping mechanisms and promote healthy peer relationships and family functioning.