COMPARISON OF PSYCHOSOCIAL ADAPTATION OF ADVANCED-STAGE HODGKINS-DISEASE AND ACUTE-LEUKEMIA SURVIVORS

Background. The purpose of this study was to compare the long-term psy chosocial adaptation of Hodgkin's disease and adult acute leukemia sur vivors. Patients and methods: Two hundred seventy-three Hodgkin's dise ase (HD) and 206 adult acute leukemia (AL) survivors were interviewed by telephone concerning their psychosocial adjustment and problems the y attributed to having been treated for cancer, using identical resear ch procedures and a common set of instruments. The following measures were used: Psychosocial Adjustment to Illness Scale (PAIS); Brief Symp tom Inventory (BSI); current Conditioned Nausea and Vomiting triggered by treatment-related stimuli (CNVI); Indices of Employment, Insurance and Sexual Problems Attributed to Cancer; Negative Socioeconomic Impa ct of Cancer Index (NSI). All participants had been treated on one of nine Hodgkin's disease or 13 acute leukemia Cancer and Leukemia Group B (CALGB) clinical trials from 1966-1988. and had been off treatment f or one year or more (mean years: HD = 5.9; AL = 5.6). Results. HD surv ivors' risk of having a high distress score on the BSI was almost twic e that found for AL survivors (odds ratio = 1.90), with 21% of HD vs. 14% of AL survivors (P < 0.05) having scores that were 1.5 standard de viations above the norm, suggestive of a possible psychiatric disorder . HD survivors reported greater fatigue (POMS Fatigue, P = 0.01; Vigor Subscales, P = 0.001), greater conditioned nausea (CNVI, P < 0.05), g reater impact of cancer on their family life (PAIS Domestic Environmen t, P = 0.004) and poorer sexual functioning (PAIS Sexual Relationships , P = 0.0001), than AL survivors. Conclusions: Treatment-related issue s may have placed HD survivors at a greater risk for problems in long- term adaptation than AL survivors.