Longitudinal changes of psychological distress among childhood cancer survivors: The Swiss Childhood Cancer Survivor Study.

BACKGROUND: Childhood cancer survivors may experience psychological distress due to the disease, cancer treatments, and potential late effects. Limited knowledge exists regarding longitudinal changes in psychological distress after childhood cancer. We aimed to determine changes in psychological distress over time and explore determinants of changes. METHODS: The Swiss Childhood Cancer Survivor Study collected data at baseline (2007-2009) and follow-up (2010-2012). Psychological distress was measured using the Brief Symptom Inventory 18 (BSI-18), including three symptom scales (somatization, depression, anxiety) and an overall distress index (Global Severity Index, GSI). Sum-scores were T-standardized (mean = 50; standard deviation [SD] = 10). Survivors with a score ≥57 on the GSI or two symptom scales were classified as cases with distress. We used linear mixed effects regression to identify potential sociodemographic and clinical determinants of change in psychological distress. RESULTS: We analyzed 696 survivors at baseline (mean age = 24 years [SD = 4], 49% females, mean time since diagnosis = 16 years [SD = 4]). On follow-up (2.4 years, SD = 1), 317 survivors were analyzed, including 302 participants with repeated measures. We found that 13% (39/302) were cases at baseline, and 25% (76/302) were cases on follow-up. Those older at study and longer since diagnosis, females, diagnosed with central nervous system (CNS) tumors, and those reporting late effects were more likely to experience higher levels of distress. Females and unemployed are at higher risk for developing or persisting psychological distress than males and those who are employed or in training. CONCLUSION: We observed an increase in psychological distress score over time, with higher proportion of psychological distress on follow-up. Anticipatory guidance and screening should be implemented in regular follow-up care.

The role of executive functions in kindergarteners' persistent and non-persistent behaviour.

The aim of the study was to examine whether cognitive skills are related to persistence. Thus, children's (N = 157, mean age: 5.9 years) persistent and non-persistent behaviours (i.e., cheating and off-task) were assessed in an unsolvable task. Additionally, we assessed children's executive functions and temperament. Analysis for persistence showed that cognitive inhibition and cognitive flexibility predicted children's persistent behaviour, beyond age and temperament. Analyses for non-persistent behaviours revealed that temperament and weak executive functions predicted cheating, while age predicted off-task behaviour. Statement of contribution What is already known on this subject? So far, persistence has been conceptualized as a temperamental sub-dimension of self-regulation. What does this study add? A child's persistence depends not only on temperament but also on cognitive inhibition and cognitive flexibility. There are qualitative differences between the two non-persistent behaviours cheating and off-task. While cheating is related to weaker cognitive skills, off-task behaviour seems mainly age-related.

Deficits of facial emotion recognition and visual information processing in adult patients with classical galactosemia.

BACKGROUND: Classical galactosemia (CG) is due to a severe deficiency of the galactose-1-phosphate uridyl-transferase (GALT), the main enzyme of galactose metabolism. Even early introduction of galactose-restricted diet fails to prevent long-term complications, including cognitive impairment, neurological and psychiatric problems, osteoporosis, premature ovarian failure and infertility. Detailed neuropsychological phenotyping is needed in order to better understand the relevant neurodevelopmental deficiencies and to develop effective treatment strategies. AIM: To define specifically and significantly impaired neuropsychological traits in adult CG patients of the Swiss cohort. METHODS: Prospective cohort study. 22 CG patients, with confirmed genotype and low GALT activity, and 15 controls completed a computer-based neuropsychological test battery (CANTAB). Additionally, broad IQ evaluation was made for the CG patients. RESULTS: In most outcome measures of the CANTAB tasks, CG patients performed significantly worse than controls. The deficits in CG patients were most prominent in tasks that involve rapid visual information processing and facial emotion recognition. CONCLUSION: CG patients have specific cognitive problems such as impaired visual information processing and facial emotion recognition. The deficits in facial emotion recognition have not been described before and could help explain difficulties in social interactions often experienced by patients with CG.