Psychiatric symptomatology in adolescents with cancer

Adolescents with cancer need to cope with their disease and treatment while accomplishing the tasks unique to this developmental period. In this pilot study, the prevalence of psychological morbidity among adolescents with cancer was examined. In addition, assessment methods and risk factors were explored. Forty-three recently diagnosed adolescents with cancer completed the Hospital Anxiety and Depression Scale (HADS), the Beck Depression Inventory (BDI), and the Rotterdam Symptom Checklist (RSCL) and underwent a full psychiatric assessment. In the psychiatric interviews, 9% of the sample was diagnosed with a depressive mood disorder. Results suggest that self-report rating scales can be useful assessment instruments if used as complementary tools. Psychosocial assessment of the adolescent with cancer is nevertheless difficult. This appears to be due to an atypical symptomatology pattern and a tendency toward the masking of distress. Case examination of depressed patients suggests that illness and treatment factors may not be primary risk factors for the development of psychological morbidity. External stressors such as poor family support and past sexual abuse, when compounded by illness and treatment factors, may be more relevant.