The Psychological Consequences of the COVID-19 Pandemic in Adults Treated for Childhood Cancer
Abstract
:1. Background
2. Methods
2.1. Study Population
2.2. French Childhood Cancer Survivors Cohort
2.3. General Population
2.4. Data Sources
2.5. Outcome Measures
2.6. Covariates
2.6.1. Demographic and Clinical and Data
2.6.2. Socioeconomic Data
2.6.3. Data on Risk Perception
2.6.4. Data on Health Care Use
2.6.5. Data on the Perceived Experience of the Pandemic
2.7. Statistical Methods
3. Results
3.1. Baseline Characteristics
3.2. Comparison of the MHI-5 Score of Respondents with the FGP
3.3. Predictors of the MHI-5 Score
3.4. Reported Consequences of the Great Lockdown and the COVID-19 Pandemic
4. Discussion
Study Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- WHO. Coronavirus Disease 2019 (COVID-19): Situation Report. Available online: https://apps.who.int/iris/handle/10665/331475 (accessed on 7 August 2021).
- WHO. Overview of Public Health and Social Measures in the Context of COVID-19: Interim Guidance. Available online: https://apps.who.int/iris/bitstream/handle/10665/332115/WHO-2019-nCoV-PHSM_Overview-2020.1-eng.pdf?sequence=1%26isAllowed=y (accessed on 3 August 2021).
- Sandford, A. Coronavirus: Half of Humanity on Lockdown in 90 Countries. Available online: https://www.euronews.com/2020/04/02/coronavirus-in-europe-spain-s-death-toll-hits-10-000-after-record-950-new-deaths-in-24-hou (accessed on 9 August 2021).
- Peretti-Watel, P.; Alleaume, C.; Léger, D.; Beck, F.; Verger, P.; COCONEL Group. Anxiety, depression and sleep problems: A second wave of COVID-19. Gen. Psychiatry 2020, 33, e100299. [Google Scholar] [CrossRef] [PubMed]
- Nicola, M.; Alsafi, Z.; Sohrabi, C.; Kerwan, A.; Al-Jabir, A.; Iosifidis, C.; Agha, M.; Agha, R. The socio-economic implications of the coronavirus pandemic (COVID-19): A review. Int. J. Surg. Lond. Engl. 2020, 78, 185–193. [Google Scholar] [CrossRef]
- Wimberly, C.E.; Towry, L.; Caudill, C.; Johnston, E.E.; Walsh, K.M. Impacts of COVID-19 on caregivers of childhood cancer survivors. Pediatr. Blood Cancer 2021, 68, e28943. [Google Scholar] [CrossRef] [PubMed]
- Marroquín, B.; Vine, V.; Morgan, R. Mental health during the COVID-19 pandemic: Effects of stay-at-home policies, social distancing behavior, and social resources. Psychiatry Res. 2020, 293, 113419. [Google Scholar] [CrossRef]
- CDC. COVID-19 and Medical Conditions. Centers for Disease Control and Prevention. Available online: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fcovid-data%2Finvestigations-discovery%2Fhospitalization-underlying-medical-conditions.html (accessed on 10 August 2021).
- Hudson, M.M.; Ness, K.K.; Gurney, J.G.; Mulrooney, D.A.; Chemaitilly, W.; Krull, K.R.; Green, D.M.; Armstrong, G.T.; Nottage, K.A.; Jones, K.E.; et al. Clinical Ascertainment of Health Outcomes among Adults Treated for Childhood Cancer: A Report from the St. Jude Lifetime Cohort Study. JAMA J. Am. Med. Assoc. 2013, 309, 2371–2381. [Google Scholar] [CrossRef] [PubMed]
- de Vathaire, F.; El-Fayech, C.; Ben Ayed, F.F.; Haddy, N.; Guibout, C.; Winter, D.; Thomas-Teinturier, C.; Veres, C.; Jackson, A.; Pacquement, H.; et al. Radiation dose to the pancreas and risk of diabetes mellitus in childhood cancer survivors: A retrospective cohort study. Lancet Oncol. 2012, 13, 1002–1010. [Google Scholar] [CrossRef]
- Forster, V.J.; Schulte, F. Unique needs of childhood cancer survivors during the COVID-19 pandemic. Support Care Cancer 2021, 29, 17–19. [Google Scholar] [CrossRef] [PubMed]
- Janah, A.; Demoor-Goldschmidt, C.; De Vathaire, F.; Bougas, N.; Clavel, J.; Poulalhon, C.; Lacour, B.; Souchard, V.; Jackson, A.; Casagranda, L.; et al. Risk perceptions and health care use in the era of the COVID-19 pandemic in adults treated for childhood cancer. Support Care Cancer 2022, 30, 6263–6271. [Google Scholar] [CrossRef]
- Zeltzer, L.K.; Recklitis, C.; Buchbinder, D.; Zebrack, B.; Casillas, J.; Tsao, J.C.I.; Lu, Q.; Krull, K. Psychological Status in Childhood Cancer Survivors: A Report from the Childhood Cancer Survivor Study. J. Clin. Oncol. 2009, 27, 2396–2404. [Google Scholar] [CrossRef]
- de Laage, A.; Allodji, R.; Dauchy, S.; Rivollet, S.; Fayech, C.; Fresneau, B.; Oberlin, O. Screening for psychological distress in very long-term adult survivors of childhood cancer. Pediatr. Hematol. Oncol. 2016, 33, 295–313. [Google Scholar] [CrossRef]
- Zebrack, B.J.; Zevon, M.A.; Turk, N.; Nagarajan, R.; Whitton, J.; Robison, L.L.; Zeltzer, L.K. Psychological distress in long-term survivors of solid tumors diagnosed in childhood: A report from the childhood cancer survivor study. Pediatr. Blood Cancer 2007, 49, 47–51. [Google Scholar] [CrossRef] [PubMed]
- FCCSS|Le Site de L’étude FCCSS. Available online: https://fccss.fr/?lang=en (accessed on 1 March 2021).
- Reulen, R.C.; Zeegers, M.P.; Jenkinson, C.; Lancashire, E.R.; Winter, D.L.; Jenney, M.E.; Hawkins, M.M. The use of the SF-36 questionnaire in adult survivors of childhood cancer: Evaluation of data quality, score reliability, and scaling assumptions. Health Qual. Life Outcomes 2006, 4, 77. [Google Scholar] [CrossRef] [Green Version]
- Rivera-Riquelme, M.; Piqueras, J.A.; Cuijpers, P. The Revised Mental Health Inventory-5 (MHI-5) as an ultra-brief screening measure of bidimensional mental health in children and adolescents. Psychiatry Res. 2019, 274, 247–253. [Google Scholar] [CrossRef]
- Mansouri, I.; Allodji, R.S.; Hill, C.; El-Fayech, C.; Pein, F.; Diallo, S.; Schwartz, B.; Vu-Bezin, G.; Veres, C.; Souchard, V.; et al. The role of irradiated heart and left ventricular volumes in heart failure occurrence after childhood cancer. Eur. J. Heart Fail. 2019, 21, 509–518. [Google Scholar] [CrossRef] [PubMed]
- Haddy, N.; Diallo, S.; El-Fayech, C.; Schwartz, B.; Pein, F.; Hawkins, M.; Veres, C.; Oberlin, O.; Guibout, C.; Pacquement, H.; et al. Cardiac Diseases Following Childhood Cancer Treatment: Cohort Study. Circulation 2016, 133, 31–38. [Google Scholar] [CrossRef] [Green Version]
- Höfler, M.; Pfister, H.; Lieb, R.; Wittchen, H.-U. The use of weights to account for non-response and drop-out. Soc. Psychiatry Psychiatr. Epidemiol. 2005, 40, 291–299. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Curtis, A.E.; Smith, T.A.; Ziganshin, B.A.; Elefteriades, J.A. The Mystery of the Z-Score. AORTA J. 2016, 4, 124–130. [Google Scholar] [CrossRef] [PubMed]
- Ayubi, E.; Bashirian, S.; Khazaei, S. Depression and Anxiety among Patients with Cancer during COVID-19 Pandemic: A Systematic Review and Meta-analysis. J. Gastrointest. Cancer 2021, 52, 499–507. [Google Scholar] [CrossRef] [PubMed]
- Rentscher, K.E.; Zhou, X.; Small, B.J.; Cohen, H.J.; Dilawari, A.A.; Patel, S.K.; Bethea, T.N.; Van Dyk, K.M.; Nakamura, Z.M.; Ahn, J.; et al. Loneliness and mental health during the COVID-19 pandemic in older breast cancer survivors and noncancer controls. Cancer 2021, 127, 3671–3679. [Google Scholar] [CrossRef] [PubMed]
- Danielle, W.L.N.; Chan, F.H.F.; Barry, T.J.; Lam, C.; Chong, C.Y.; Kok, H.C.S.; Liao, Q.; Fielding, R.; Lam, W.W.T. Psychological distress during the 2019 Coronavirus Disease (COVID-19) pandemic among cancer survivors and healthy controls. Psychooncology 2020, 29, 1380–1383. [Google Scholar]
- Islam, J.Y.; Vidot, D.C.; Camacho-Rivera, M. Evaluating Mental Health–Related Symptoms among Cancer Survivors during the COVID-19 Pandemic: An Analysis of the COVID Impact Survey. JCO Oncol. Pract. 2021, 17, e1258–e1269. [Google Scholar] [CrossRef]
- Michel, G.; Rebholz, C.E.; von der Weid, N.X.; Bergstraesser, E.; Kuehni, C.E. Psychological distress in adult survivors of childhood cancer: The Swiss Childhood Cancer Survivor study. J. Clin. Oncol. Off. J. Am. Soc. Clin. Oncol. 2010, 28, 1740–1748. [Google Scholar] [CrossRef]
- Zeltzer, L.K.; Lu, Q.; Leisenring, W.; Tsao, J.C.I.; Recklitis, C.; Armstrong, G.; Mertens, A.C.; Robison, L.L.; Ness, K.K. Psychosocial Outcomes and Health-Related Quality of Life in Adult Childhood Cancer Survivors: A Report from the Childhood Cancer Survivor Study. Cancer Epidemiol. Prev. Biomark. 2008, 17, 435–446. [Google Scholar] [CrossRef] [Green Version]
- Zebrack, B.J.; Stuber, M.L.; Meeske, K.A.; Phipps, S.; Krull, K.R.; Liu, Q.; Parry, C.; Hamilton, R.; Robison, L.L.; Zeltzer, L.K. Perceived Positive Impact of Cancer among Long-term Survivors of Childhood Cancer: A report from the Childhood Cancer Survivor Study. Psychooncology 2012, 21, 630–639. [Google Scholar] [CrossRef] [Green Version]
- Prouty, D.; Ward-Smith, P.; Hutto, C.J. The Lived Experience of Adult Survivors of Childhood Cancer. J. Pediatr. Oncol. Nurs. 2006, 23, 143–151. [Google Scholar] [CrossRef]
- Aarts, M.J.; Mols, F.; Thong, M.S.Y.; Louwman, M.W.; Coebergh, J.W.W.; van de Poll-Franse, L.V. Long-term prostate cancer survivors with low socioeconomic status reported worse mental health-related quality of life in a population-based study. Urology 2010, 76, 1224–1230. [Google Scholar] [CrossRef]
- INCa. La Vie Cinq ans Après un Diagnostic de Cancer; Collection: Etat des lieux et des connaissances/Recherche, The National Cancer Institute (INCa), Boulogne-Billancourt, France, 2018; p. 364.
- Kale, H.P.; Carroll, N.V. Self-reported financial burden of cancer care and its effect on physical and mental health-related quality of life among US cancer survivors. Cancer 2016, 122, 283–289. [Google Scholar] [CrossRef]
- McLean, C.P.; Asnaani, A.; Litz, B.T.; Hofmann, S.G. Gender differences in anxiety disorders: Prevalence, course of illness, comorbidity and burden of illness. J. Psychiatr. Res. 2011, 45, 1027–1035. [Google Scholar] [CrossRef] [Green Version]
- O’Connor, R.C.; Wetherall, K.; Cleare, S.; McClelland, H.; Melson, A.J.; Niedzwiedz, C.L.; O’Carroll, R.E.; O’Connor, D.B.; Platt, S.; Scowcroft, E.; et al. Mental health and well-being during the COVID-19 pandemic: Longitudinal analyses of adults in the UK COVID-19 Mental Health & Wellbeing study. Br. J. Psychiatry 2021, 218, 326–333. [Google Scholar]
- Pierce, M.; Hope, H.; Ford, T.; Hatch, S.; Hotopf, M.; John, A.; Kontopantelis, E.; Webb, R.; Wessely, S.; McManus, S.; et al. Mental health before and during the COVID-19 pandemic: A longitudinal probability sample survey of the UK population. Lancet Psychiatry 2020, 7, 883–892. [Google Scholar] [CrossRef]
- Proto, E.; Quintana-Domeque, C. COVID-19 and mental health deterioration by ethnicity and gender in the UK. PLoS ONE 2021, 16, e0244419. [Google Scholar] [CrossRef]
- Lambert, A.; Cayouette-Remblière, J.; Guéraut, É.; Roux, G.L.; Bonvalet, C.; Girard, V.; Langlois, L. How the COVID-19 epidemic changed working conditions in France. Popul. Soc. 2020, 579, 1–4. [Google Scholar]
- Guignot, C. Détresse Psychologique des Français Pendant le Confinement: Premiers Enseignements de L’enquête COCLICO. Available online: https://www.univadis.fr/viewarticle/detresse-psychologique-des-francais-pendant-le-confinement-premiers-enseignements-de-l-enquete-coclico-723694 (accessed on 5 August 2021).
- Oreffice, S.; Quintana-Domeque, C. Gender inequality in COVID-19 times: Evidence from UK prolific participants. J. Demogr. Econ. 2021, 87, 261–287. [Google Scholar] [CrossRef]
- Zebrack, B.J.; Gurney, J.G.; Oeffinger, K.; Whitton, J.; Packer, R.J.; Mertens, A.; Turk, N.; Castleberry, R.; Dreyer, Z.; Robison, L.L.; et al. Psychological outcomes in long-term survivors of childhood brain cancer: A report from the childhood cancer survivor study. J. Clin. Oncol. Off. J. Am. Soc. Clin. Oncol. 2004, 22, 999–1006. [Google Scholar] [CrossRef]
- Nulty, D.D. The adequacy of response rates to online and paper surveys: What can be done? Assess. Eval. High. Educ. 2008, 33, 301–314. [Google Scholar] [CrossRef] [Green Version]
Non-Respondents | Respondents | ||||
---|---|---|---|---|---|
n = 2148 (79%) | n = 580 (21%) | ||||
N | % | N | % | p | |
Age at survey (years) | <0.0001 | ||||
<39 | 1074 | 50 | 221 | 38 | |
40–49 | 720 | 34 | 222 | 38 | |
≥50 | 354 | 16 | 137 | 24 | |
Gender | 0.5376 | ||||
Men | 1042 | 49 | 273 | 47 | |
Women | 1106 | 51 | 307 | 53 | |
Education level | <0.0001 | ||||
Less than high school | 396 | 19 | 81 | 14 | |
High school graduate | 758 | 37 | 154 | 27 | |
College graduate | 924 | 44 | 339 | 59 | |
Decade of diagnosis of first cancer | <0.0001 | ||||
<1970 | 98 | 5 | 55 | 9 | |
1970–1979 | 330 | 15 | 132 | 23 | |
1980–1989 | 792 | 37 | 186 | 32 | |
≥1990 | 928 | 43 | 207 | 36 | |
Childhood cancer type | 0.0024 | ||||
Nephroblastoma | 329 | 15 | 109 | 19 | |
Neuroblastoma | 316 | 15 | 94 | 16 | |
Lymphoma | 418 | 19 | 116 | 20 | |
Soft tissue sarcoma | 222 | 10 | 66 | 11 | |
Bone | 226 | 11 | 59 | 10 | |
Brain tumor | 245 | 12 | 32 | 6 | |
Other † | 392 | 18 | 104 | 18 | |
Chemotherapy | 0.6177 | ||||
No | 422 | 21 | 110 | 20 | |
Yes | 1630 | 79 | 451 | 80 | |
Radiotherapy | 0.0305 | ||||
No | 1075 | 52 | 265 | 47 | |
Yes | 977 | 48 | 296 | 53 | |
Second cancer‡ | 0.2856 | ||||
No | 1895 | 92 | 511 | 91 | |
Yes | 158 | 8 | 51 | 9 | |
Diabetes‡ | 0.0065 | ||||
No | 2097 | 98 | 554 | 96 | |
Yes | 51 | 2 | 26 | 4 | |
Cardiac disease‡ | 0.0001 | ||||
No | 2028 | 95 | 522 | 90 | |
Grades 1 and 2 | 42 | 2 | 25 | 4 | |
Grades ≥ 3 | 69 | 3 | 32 | 6 |
MHI-5 Scores | |||||
Overall MHI-5 score | By gender | ||||
All (n = 505) | Men (n = 238) | Women (n = 267) | |||
Mean Z-score (95% CI) | Mean Z-score (95% CI) | Mean Z-score (95% CI) | |||
−0.01 (−0.10 to 0.08) | 0.11 (−0.02 to 0.23) | −0.11 (−0.24 to 0.02) | |||
By educational level | |||||
Less than high school (n = 62) | High school graduate (n = 127) | College graduate (n = 316) | |||
Mean Z-score (95% CI) | Mean Z-score (95% CI) | Mean Z-score (95% CI) | |||
0.15 (−0.10 to 0.39) | −0.16 (−0.36 to 0.04) | 0.04 (−0.07 to 0.15) | |||
By second cancer | |||||
No (n = 440) | Yes (n = 47) | ||||
Mean Z-score (95% CI) | Mean Z-score (95% CI) | ||||
−0.02 (−0.11 to 0.08) | 0.04 (−0.29 to 0.37) | ||||
By cardiac disease | |||||
No (n = 453) | Yes (n = 52) | ||||
Mean Z-score (95% CI) | Mean Z-score (95% CI) | ||||
−0.00 (−0.10 to 0.09) | −0.05 (−0.37 to 0.26) |
Univariate Analyses | Multivariate Analyses (n = 497) | |||
Unadjusted β and 95% CI | p | Adjusted β and 95% CI | p | |
Age at the survey (years) | 0.12 [0.04 to 0.21] | 0.0037 | 0.10 [0.01 to 0.19] | 0.0315 |
Gender | ||||
Women | −4.76 [−6.40 to −3.11] | <0.0001 | −3.55 [−5.20 to −1.89] | <0.0001 |
Decade of diagnosis of first cancer | ||||
≥1990 versus earlier | −2.33 [−4.02 to −0.64] | 0.0071 | ||
Education level | ||||
Less than high school | 1.84 [−0.40 to 4.07] | 0.1066 | - | |
High school graduate | −2.58 [−4.35 to −0.82] | 0.0042 | −1.18 [−2.89 to 0.53] | 0.1761 |
College graduate | 1.29 [−0.40 to 2.97] | 0.1342 | - | |
Chemotherapy | 0.84 [−1.35 to 3.03] | 0.4498 | 2.35 [0.25 to 4.46] | 0.0287 |
Radiotherapy | 0.90 [−0.82 to 2.63] | 0.3047 | 0.20 [−1.51 to 1.90] | 0.8190 |
Second cancer | 0.60 [−2.46 to 3.66] | 0.7002 | −0.64 [−3.52 to 2.25] | 0.6643 |
Cardiac disease | −0.38 [−3.32 to 2.57] | 0.8015 | 0.39 [−2.39 to 3.16] | 0.7847 |
Having a relative who had been hospitalized or had died following COVID-19 | −3.34 [−5.57 to −1.10] | 0.0035 | −2.70 [−4.81 to −0.58] | 0.0126 |
Change of occupational situation during the great lockdown | ||||
Termination of the contract by the employer | −9.61 [−15.12 to −4.10] | 0.0007 | −7.64 [−12.87 to −2.42] | 0.0042 |
Stop or significant decrease in professional activity (self-employed) | −5.60 [−9.60 to −1.61] | 0.0061 | −7.50 [−11.13 to −3.86] | <0.0001 |
Fear that health might be endangered by the working conditions due to the COVID-19 pandemic | −2.77 [−4.97 to −0.57] | 0.0137 | −1.44 [−3.55 to 0.67] | 0.1809 |
Forgoing health care since the start of the pandemic | −3.08 [−6.01 to −0.99] | 0.0039 | ||
Remembering childhood cancer more during the great lockdown | −3.82 [−5.59 to −2.05] | <0.0001 | −2.45 [−4.20 to −0.70] | 0.0061 |
Number of rooms in the house | 1.15 [0.71 to 1.59] | <0.0001 | 0.47 [−0.04 to 0.98] | 0.0728 |
Presence of a garden in the house | 4.47 [2.77 to 6.16] | <0.0001 | 2.58 [0.55 to 4.61] | 0.0127 |
Perceived infection risk | −0.95 [−1.24 to −0.66] | <0.0001 | −0.68 [−0.98 to −0.37] | <0.0001 |
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Janah, A.; Haddy, N.; Demoor-Goldschmidt, C.; Bougas, N.; Clavel, J.; Poulalhon, C.; Lacour, B.; Souchard, V.; Jackson, A.; Casagranda, L.; et al. The Psychological Consequences of the COVID-19 Pandemic in Adults Treated for Childhood Cancer. Curr. Oncol. 2022, 29, 4104-4116. https://doi.org/10.3390/curroncol29060327
Janah A, Haddy N, Demoor-Goldschmidt C, Bougas N, Clavel J, Poulalhon C, Lacour B, Souchard V, Jackson A, Casagranda L, et al. The Psychological Consequences of the COVID-19 Pandemic in Adults Treated for Childhood Cancer. Current Oncology. 2022; 29(6):4104-4116. https://doi.org/10.3390/curroncol29060327
Chicago/Turabian StyleJanah, Asmaa, Nadia Haddy, Charlotte Demoor-Goldschmidt, Nicolas Bougas, Jacqueline Clavel, Claire Poulalhon, Brigitte Lacour, Vincent Souchard, Angela Jackson, Leonie Casagranda, and et al. 2022. "The Psychological Consequences of the COVID-19 Pandemic in Adults Treated for Childhood Cancer" Current Oncology 29, no. 6: 4104-4116. https://doi.org/10.3390/curroncol29060327
APA StyleJanah, A., Haddy, N., Demoor-Goldschmidt, C., Bougas, N., Clavel, J., Poulalhon, C., Lacour, B., Souchard, V., Jackson, A., Casagranda, L., Berger, C., Allodji, R., El Fayech, C., Fresneau, B., De Vathaire, F., & Dumas, A. (2022). The Psychological Consequences of the COVID-19 Pandemic in Adults Treated for Childhood Cancer. Current Oncology, 29(6), 4104-4116. https://doi.org/10.3390/curroncol29060327