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Survivors of childhood ALL experience behavioural, emotional problems

13 Jun 2018

Child and adolescent long-term survivors of acute lymphoblastic leukaemia (ALL) may suffer from psychological symptoms, such as inattention and oppositional behaviour, a recent study has reported.

Using self- and parent-accomplished questionnaires, researchers assessed behavioural and emotional symptoms in 161 survivors of childhood ALL (mean age 12.1±2.6 years; 51.0 percent female). One-sample binomial tests were used to compare findings in the study population with normative data. Parent emotional distress was also measured.

Compared to the 10-percent population expectation, significantly more ALL survivors self-reported inattention (27.9 percent; 95 percent CI, 21.0–35.7), hyperactivity/impulsivity (26.0 percent; 19.2–33.6 percent) and oppositional-defiant behaviours (20.1 percent; 14.1–27.3).

Parent reports confirmed the findings for inattention (23.6 percent; 17.2–31.0) and showed that oppositional defiant disorder (16.0 percent vs 9.5 percent) and obsessive-compulsive disorder (10.3 percent vs 2 percent) were more common in survivors than in general population.

In contrast, frequencies of generalized anxiety disorder (3.2 percent vs 4.1 percent) and attention-deficit/hyperactivity disorder (7.1 percent vs 7.8 percent) did not show marked differences with normalized data, according to parent reports.

Notably, parent self-report of post-traumatic stress symptoms, depression and anxiety appeared to increase the risk of parent-report of child anxiety, obsessive compulsive disorder and atypicality.

“Preventative interventions targeting behavioural outcomes in paediatric patients with ALL and, when present, emotional distress in parents should be considered. Family therapy that includes both the parent and survivor may also be beneficial for those survivors with oppositional behaviour,” said researchers.

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