Treatment of Anxiety and Depression in Adolescents and Young Adults With Cancer.

Adolescents and young adults (AYAs) with cancer are a unique population of patients who experience a period of intense and dramatic life changes when they are diagnosed. Overall, AYAs with cancer are resilient; however, their psychosocial needs are often underestimated or unmet. Currently, there are inconsistencies in how AYAs are screened and treated for anxiety and depression. Barriers to treatment include clinicians' lack of confidence in distinguishing between side effects of treatment and depression/anxiety. Additional barriers include the black box warning for prescribing antidepressants and difficulty partnering with mental health professionals. This article seeks to provide recommendations for pediatric oncology clinicians on how to identify and address anxiety and depression in AYAs and how to partner with mental health professionals in their treatment, and it suggests directions for future research.

Assessing Suicidal Ideation and Behaviors Among Survivors of Childhood Brain Tumors and Their Mothers During Sociobehavioral Research.

PURPOSE/OBJECTIVES: To describe the development and feasibility of a protocol for nonpsychiatric subspecialty research staff members to screen research participants who endorse suicidal ideations or behaviors during data collection
. DESIGN: Descriptive protocol development.
. SETTING: The Children's Hospital of Philadelphia and the University of Pennsylvania.
. SAMPLE: 186 mother caregivers and 134 adolescent or young adult survivors of childhood brain tumors, with the protocol implemented for 5 caregivers and 11 survivors. METHODS: During telephone- and home-based interviews, the interviewer assessed the participant using the Columbia-Suicide Severity Rating Scale (C-SSRS). MAIN RESEARCH VARIABLES: Expressed suicidal ideation or behavior
. FINDINGS: Implementation of the C-SSRS by nonpsychiatric subspecialty staff members was feasible and valid. Interviewers' conclusions based on this instrument matched those of the mental health professional who followed up with participants. Process notes contained themes about the participants, including anger and sadness in survivors and the physical and emotional demands of the survivor in caregivers. Progress notes for the interviewer included a reiteration of events, whether the assessment was successful, and whether the recommendation of the interviewer was in agreement with that of the mental health professional
. CONCLUSIONS: The protocol based on the C-SSRS was useful and feasible for nonpsychiatric subspecialty staff members to use in the collection of data from survivors of childhood brain tumors and their caregivers. IMPLICATIONS FOR NURSING: Survivors of childhood brain tumors and their caregivers may experience psychosocial distress. Nurses, as research assistants or in other roles, can use tools such as the C-SSRS to assist in front-line assessments. 
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