Psychiatric Morbidity in Children Undergoing Treatment for Acute Lymphoblastic Leukemia

Treatment of pediatric Acute lymphoblastic leukaemia (ALL) is one of the greatest success stories in medicine. Research done in ALL survivors has shown that intensive treatment received leads to development psychiatric illnesses in cancer patients and survivors. Very few studies have evaluated children who are recently diagnosed or while on therapy. This study was done to evaluate the occurrence of psychological morbidity in children with ALL, undergoing treatment, using Childhood Psychopathology Measurement Schedule (CPMS) score and to observe the association of psychological morbidity with various patient variables. This cross sectional observational study was carried out in a tertiary care hospital in North India in patients of ALL on therapy aged 6-16 years. Those with neurological symptoms such as seizure, meningitis; already suffering from any neurological disorder; and patients with terminal illness were excluded. Subjects were screened for presence of psychopathology using Childhood Psychopathology Measurement Schedule (CPMS). Sixty ALL patients with a mean age of 9.53 ± 2.37 years were enrolled of which 14 (23.3%) had a positive CPMS screen. Occurrence of a positive screen was higher in patients with higher risk disease (P = 0.044), those in early intensive phases of chemotherapy (P = 0.137) and those belonging to lower socioeconomic strata (P = 0.03). Prevalence of a positive psychopathology screen in children receiving treatment for ALL is quite high, hence it is suggested to screen them while in initial phases of therapy so that early intervention can be done.