ANXIETY AND DEPRESSION IN ADOLESCENT CANCER - FINDINGS IN PATIENTS AND PARENTS AT THE TIME OF DIAGNOSIS

Adolescent cancer is uncommon and presents an exceptional stress for t he young patient and their parents. The emotional needs of adolescents with cancer are a major factor in the recommendation for the establis hment of adolescent cancer units in major cancer centres in the U.K. H owever, there have been no prospective, longitudinal studies assessing the psychological impact of a diagnosis of cancer on the adolescent p atient and their family. In 1994 we began a longitudinal study of the emotional impact of the diagnosis of cancer in patients and their fami lies presenting to an adolescent cancer unit and of the coping strateg ies they employ. This first report presents the results of the study a t the time of diagnosis in 42 adolescents, 34 mothers and 27 fathers. The Beck Depression Inventory (BDI) was used to assess depression and anxiety levels were measured using Spielberger's State Trait Anxiety I nventory (STAI). Adolescents and their parents completed the questionn aires on first admission to the adolescent cancer unit. The median tim e since cancer diagnosis was approximately 3 weeks. To provide normati ve data for the U.K, adolescent population, control values were obtain ed from 173 pupils of the same age and background. The results showed that, contrary to expectation, adolescents with cancer were no more an xious or depressed than the control adolescent population. Nevertheles s, a substantial minority of patients and controls had elevated anxiet y or depression scores. Girls were significantly more anxious (P=0.011 ) and depressed (P<0.0001) than boys. Mothers were the most anxious fa mily members and were significantly more anxious than fathers (P=0.038 ). Parental anxiety scores, especially mothers, were much higher than reported norms. There was no significant difference between mothers' a nd fathers' depression scores. Although at the time of diagnosis adole scent cancer patients are not more anxious or depressed than their hea lthy peers, many adolescents without cancer are anxious or depressed. Staff on adolescent cancer units should therefore be aware of the freq uency of emotional disturbance in this population. Mothers are the mos t anxious family members. Although the findings are relatively reassur ing at the time of diagnosis, follow-up data from this cohort will sho w whether anxiety and depression change with treatment involving inten sive chemotherapy, surgery and radiotherapy and will indicate the copi ng strategies which patients and their families adopt in dealing with both the disease and its treatment. (C) 1997 Published by Elsevier Sci ence Ltd.