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Children's psychological distress during pediatric HSCT: parent and child perspectives

Grace Chang1, Sara J Ratichek, Christopher Recklitis

  • 1Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA. gchang@partners.org

Pediatric Blood & Cancer
|May 28, 2011
PubMed

Insights

Pediatric hematopoietic stem cell transplantation (HSCT) is linked to significant anxiety and mood symptoms in children. Parent and child reports of these psychological issues often disagree, highlighting the need for combined input for effective interventions.

Area of Science:

  • Pediatric Hematology
  • Child Psychology
  • Transplantation Medicine

Background:

  • Hematopoietic stem cell transplantation (HSCT) presents unique challenges for pediatric patients and their families.
  • Limited understanding exists regarding the psychological well-being of pediatric HSCT recipients during treatment initiation and the subsequent year.
  • This study addresses the psychological status of pediatric HSCT recipients through parental perspectives and parent-child agreement.

Purpose of the Study:

  • To describe the psychological status of 107 pediatric HSCT recipients from their parents' viewpoint.
  • To compare psychological distress reports between parents and children in a subset of 55 pediatric HSCT recipients.
  • To investigate potential discrepancies in the perception of psychological symptoms between parents and children undergoing HSCT.

Main Methods:

  • A multi-site, prospective study involving 107 pediatric HSCT recipients and their parents.
  • Utilized selected modules from the Structured Clinical Interview for DSM-IV-TR, Childhood Version (KID-SCID) pre-HSCT and 12 months post-HSCT.
  • Assessed both threshold and subthreshold diagnoses for anxiety and mood disorders.

Main Results:

  • Parents reported anxiety disorders in nearly 30% of children pre- and post-HSCT, with about half meeting full diagnostic criteria.
  • Parent-child agreement on anxiety disorders was poor at baseline (κ = -0.18) and fair at 12 months (κ = 0.31).
  • Agreement on mood disorders was fair at baseline (κ = 0.39) and moderate at 12 months (κ = 0.41), with prevalence rates of 10% and 14%, respectively.

Conclusions:

  • Anxiety (30%) and mood (10-14%) symptoms are prevalent in pediatric HSCT recipients both before and after transplantation.
  • Significant discrepancies exist between parental and child self-reports of these psychological symptoms.
  • Integrating both parent and child input is crucial for accurately identifying children needing additional support during and after HSCT.
Abstract

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