Post-traumatic stress disorder and symptoms in paediatric cancer survivors and their family nucleus: systematic review, meta-analysis and meta-regression

Background Various studies have highlighted the increased incidence and symptoms of depression and anxiety in paediatric cancer survivors (PCS). Yet no meta-analysis has focused on post-traumatic stress disorder (PTSD) or post-traumatic stress symptoms (PTSS) in PCS and their family nucleus. Aims T...

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Main Authors: Chen Ee Low, Sheryl Yen Pin Tan, Andre Loh, Jingrong Yu, Joel Zuo Er Ong, Caitlin Yuen Ling Loh, Chun En Yau, Ainsley Ryan Yan Bin Lee, Cyrus Su Hui Ho
Format: Article
Language:English
Published: Cambridge University Press 2024-11-01
Series:BJPsych Open
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Online Access:https://www.cambridge.org/core/product/identifier/S2056472424008056/type/journal_article
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author Chen Ee Low
Sheryl Yen Pin Tan
Andre Loh
Jingrong Yu
Joel Zuo Er Ong
Caitlin Yuen Ling Loh
Chun En Yau
Ainsley Ryan Yan Bin Lee
Cyrus Su Hui Ho
author_facet Chen Ee Low
Sheryl Yen Pin Tan
Andre Loh
Jingrong Yu
Joel Zuo Er Ong
Caitlin Yuen Ling Loh
Chun En Yau
Ainsley Ryan Yan Bin Lee
Cyrus Su Hui Ho
author_sort Chen Ee Low
collection DOAJ
description Background Various studies have highlighted the increased incidence and symptoms of depression and anxiety in paediatric cancer survivors (PCS). Yet no meta-analysis has focused on post-traumatic stress disorder (PTSD) or post-traumatic stress symptoms (PTSS) in PCS and their family nucleus. Aims To evaluate the overall risk of PTSD and severity of PTSS in PCS and their family nucleus. Secondary objectives include identifying potential risk factors of PTSD and high PTSS. Method We systematically searched PubMed, Embase and PsycINFO for studies comparing the risk of PTSD and PTSS severity among PCS, their family nucleus and non-cancer controls. PRISMA reporting guidelines were followed. Random effects meta-analyses and meta-regressions were conducted. Results From 1089 records, we included 21 studies. PCS have an increased risk of PTSD (risk ratio 2.36, 95% CI 1.37–4.06) and decreased PTSS severity (standardised mean difference −0.29, 95% CI −0.50 to −0.08). Subgroup analyses of other categorical study-level characteristics revealed that female PCS who were older at diagnosis and data collection had a significantly higher risk of PTSD. Meta-regression were insignificant. Family nucleus did not show a significantly increased risk of PTSD (risk ratio 1.13, 95% CI 0.59–5.00) and PTSS severity (standardised mean difference 0.53, 95% CI −0.00 to 1.06). Systematically reviewing studies on the family nucleus found that the majority reported a significantly increased risk of psychological trauma compared with the comparator. Lower education, income and social status were also risk factors. Conclusions Timely identification and interventions are imperative for policy makers and healthcare providers to prevent trauma from worsening in this population group.
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spelling doaj-art-791df11bb4094e189f6bd2cf6f53af0c2024-11-11T07:03:03ZengCambridge University PressBJPsych Open2056-47242024-11-011010.1192/bjo.2024.805Post-traumatic stress disorder and symptoms in paediatric cancer survivors and their family nucleus: systematic review, meta-analysis and meta-regressionChen Ee Low0https://orcid.org/0000-0002-8652-0984Sheryl Yen Pin Tan1Andre Loh2Jingrong Yu3Joel Zuo Er Ong4Caitlin Yuen Ling Loh5Chun En Yau6Ainsley Ryan Yan Bin Lee7Cyrus Su Hui Ho8Yong Loo Lin School of Medicine, National University of Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, SingaporeDepartment of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; and Department of Psychological Medicine, National University Hospital, SingaporeBackground Various studies have highlighted the increased incidence and symptoms of depression and anxiety in paediatric cancer survivors (PCS). Yet no meta-analysis has focused on post-traumatic stress disorder (PTSD) or post-traumatic stress symptoms (PTSS) in PCS and their family nucleus. Aims To evaluate the overall risk of PTSD and severity of PTSS in PCS and their family nucleus. Secondary objectives include identifying potential risk factors of PTSD and high PTSS. Method We systematically searched PubMed, Embase and PsycINFO for studies comparing the risk of PTSD and PTSS severity among PCS, their family nucleus and non-cancer controls. PRISMA reporting guidelines were followed. Random effects meta-analyses and meta-regressions were conducted. Results From 1089 records, we included 21 studies. PCS have an increased risk of PTSD (risk ratio 2.36, 95% CI 1.37–4.06) and decreased PTSS severity (standardised mean difference −0.29, 95% CI −0.50 to −0.08). Subgroup analyses of other categorical study-level characteristics revealed that female PCS who were older at diagnosis and data collection had a significantly higher risk of PTSD. Meta-regression were insignificant. Family nucleus did not show a significantly increased risk of PTSD (risk ratio 1.13, 95% CI 0.59–5.00) and PTSS severity (standardised mean difference 0.53, 95% CI −0.00 to 1.06). Systematically reviewing studies on the family nucleus found that the majority reported a significantly increased risk of psychological trauma compared with the comparator. Lower education, income and social status were also risk factors. Conclusions Timely identification and interventions are imperative for policy makers and healthcare providers to prevent trauma from worsening in this population group. https://www.cambridge.org/core/product/identifier/S2056472424008056/type/journal_articleTrauma and stressor-related disorderssystematic reviewchild and adolescent psychiatrymeta-analysiscarers
spellingShingle Chen Ee Low
Sheryl Yen Pin Tan
Andre Loh
Jingrong Yu
Joel Zuo Er Ong
Caitlin Yuen Ling Loh
Chun En Yau
Ainsley Ryan Yan Bin Lee
Cyrus Su Hui Ho
Post-traumatic stress disorder and symptoms in paediatric cancer survivors and their family nucleus: systematic review, meta-analysis and meta-regression
BJPsych Open
Trauma and stressor-related disorders
systematic review
child and adolescent psychiatry
meta-analysis
carers
title Post-traumatic stress disorder and symptoms in paediatric cancer survivors and their family nucleus: systematic review, meta-analysis and meta-regression
title_full Post-traumatic stress disorder and symptoms in paediatric cancer survivors and their family nucleus: systematic review, meta-analysis and meta-regression
title_fullStr Post-traumatic stress disorder and symptoms in paediatric cancer survivors and their family nucleus: systematic review, meta-analysis and meta-regression
title_full_unstemmed Post-traumatic stress disorder and symptoms in paediatric cancer survivors and their family nucleus: systematic review, meta-analysis and meta-regression
title_short Post-traumatic stress disorder and symptoms in paediatric cancer survivors and their family nucleus: systematic review, meta-analysis and meta-regression
title_sort post traumatic stress disorder and symptoms in paediatric cancer survivors and their family nucleus systematic review meta analysis and meta regression
topic Trauma and stressor-related disorders
systematic review
child and adolescent psychiatry
meta-analysis
carers
url https://www.cambridge.org/core/product/identifier/S2056472424008056/type/journal_article
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