RESUMO
Purpose: This study evaluated the long-term psychological impact of childhood cancer and also sought to identify the risk factors in the development of psychological issues. Methods: Young adult (18-38 years) survivors of a childhood cancer (except leukemia), diagnosed younger than 15 years between 1987 and 1999 in the Rhône-Alpes region of France, were invited to a semistandardized psychological interview after a medical follow-up consultation during two successive long-term follow-up studies in Oncology (SALTO-1 and -2). Psychiatric issues from the DSM-IV were diagnosed and compared with the general French population (GFP) through interviews based on the Mini-International Neuropsychiatric Interview (MINI). Results: Of the 288 childhood cancer survivors (CCSs) who attended the consultations, 247 completed the MINI interview. Fifty-five percent indicated they had suffered from psychiatric issues after their cancer compared to 31.9% of the GFP (p < 0.0001). These issues were generally anxiety problems (40.5%), mood disorders (28.7%), and substance dependency (10.5%; p < 0.0001). The risk of suicide was, however, less for the CCS group (8.9% vs. 13.6%, p = 0.03). Unemployment was a significant risk factor for mood disorders (p = 0.009). Men were 4.1 times more likely than women to be addicted during their lifetime (p = 0.0004), while adults cured of bone tumors were 14.3 times more likely to be at risk of drug dependence than adults cured of central nervous system tumors (p = 0.01). Conclusion: CCSs are particularly vulnerable to psychiatric disorders throughout their life. Systematic and long-term psychological monitoring of these patients will enable their psychiatric issues to be detected sooner.
