A controlled study of major depressive episodes in long‐term childhood, adolescence, and young adult cancer survivors (The nor‐cayacs study)

Abstract

Background: A major depressive episode (MDE) is typically self‐rated by screening forms identifying probable MDE (pMDE). This population‐based cross‐sectional questionnaire study examined the prevalence rates of pMDE identified by the PHQ‐9 screener in long‐term survivors of childhood and adolescence (CACSs) and young adult cancer (YACSs) and a normative sample (NORMs). Methods: Data from 488 CACSs, 1202 YACSs, and 1453 NORMs were analyzed, and pMDE was defined both by cut‐off ≥10 on the total PHQ‐9 score and by an algorithm. Results: The prevalence rates of pMDE among CACSs were 21.5%, 16.6% in YACSs, and 9.2% among NORMs using the cut‐off definition. With the algorithm, the prevalence rates of pMDE were 8.0% among CACSs, 8.1% among YACSs, and 3.9% among NORMs. Independent of definition, CACSs and YACSs had significantly increased prevalence rates of pMDE compared to NORMs. Psychosocial factors and self‐rated health were significantly associated with both definitions of pMDE in multivariable analyses, while survivor groups, cancer types, and adverse events were not. Conclusion: Since pMDE has negative health consequences and is amenable to treatment, healthcare providers should be attentive and screen for pMDE in young cancer survivors. For PHQ‐9, the preferred type of definition of pMDE should be determined.