Vicky Lehmann

Negative and positive consequences of adolescent cancer 10 years after diagnosis : an interview-based longitudinal study in Sweden

The aim of this study was to provide insight into survivor‐reported negative and positive consequences of cancer during adolescence 10 years after diagnosis and compare these with consequences reported 3 and 4 years after diagnosis.

The human and animal baby schema effect: correlates of individual differences.

We investigated the animal and human baby schema effect (BSE) in relation to gender, parental status, and individual features. In three, independent online surveys, conducted during three consecutive years, (Ntotal=1389), ratings of photographs of human and animal infants as well as of adults, sociodemographic variables (age, gender, parental status) and personality attributes (empathy, attachment, interpersonal closeness, narcissism, and need to belong) were assessed. We demonstrated that humans are sensitive to the baby schemata of both humans and animals and that both are weakly positively correlated. BSE is positively associated with female gender and (affective) empathy. Higher interpersonal closeness and need to belong were additionally connected specifically to the human BSE. In contrast, narcissism and insecure attachment were not related to the BSE, suggesting a robustness of this phenomenon to possible negative influences of these two personality attributes.

Supporting Siblings as a Standard of Care in Pediatric Oncology

In this study, evidence is provided for supporting siblings as a standard of care in pediatric oncology. Using Medline, PsycInfo, and CINAHL, a systematic search of articles published over the past two decades about siblings of children with cancer was conducted. A total of 125 articles, which were primarily descriptive studies, were evaluated by the four investigators using Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. There is moderate‐quality evidence, as well as support from community stakeholders, to justify a strong recommendation that siblings of children with cancer should be provided with psychosocial services and that parents and professionals are advised about how to meet siblings’ needs.

Somatic comorbidity in anorexia nervosa: First results of a 21-year follow-up study on female inpatients.

BackgroundAnorexia nervosa is a severe psychosomatic disease with somatic complications in the long-term course and a high mortality rate. Somatic comorbidities independent of anorexia nervosa have rarely been studied, but pose a challenge to clinical practitioners. We investigated somatic comorbidities in an inpatient cohort and compared somatically ill anorexic patients and patients without a somatic comorbidity. In order to evaluate the impact of somatic comorbidity for the long-term course of anorexia nervosa, we monitored survival in a long-term follow-up.MethodOne hundred and sixty-nine female inpatients with anorexia nervosa were treated at the Charité University Medical Centre, Campus Benjamin Franklin, Berlin, between 1979 and 2011. We conducted retrospective analyses using patients medical and psychological records. Information on survival and mortality were required through the local registration office and was available for one hundred patients. The mean follow-up interval for this subgroup was m = 20.9 years (sd = 4.7, min = 13.3, max = 31.6, range = 18.3). We conducted survival analysis using cox regression and included somatic comorbidity in a multivariate model.ResultsN = 41 patients (24.3%) showed a somatic comorbidity, n = 13 patients (7.7%) showed somatic comorbidities related to anorexia nervosa and n = 26 patients (15.4%) showed somatic comorbidities independent of anorexia nervosa, n = 2 patients showed somatic complications related to other psychiatric disorders. Patients with a somatic comorbidity were significantly older (m = 29.5, sd = 10.3 vs m = 25.0, sd = 8.7; p = .006), showed a later anorexia nervosa onset (m = 24.8, sd = 9.9 vs. m = 18.6, sd = 5.1; p < .000) and a longer duration of treatment in our clinic (m = 66.6, sd = 50.3 vs. m = 50.0, sd = 47; p = .05) than inpatients without somatic comorbidity. Out of 100 patients, 9 patients (9%) had died, on average at age of m = 37 years (sd = 9.5). Mortality was more common among inpatients with somatic comorbidity (n = 6, 66.7%) than among inpatients without a somatic disease (n = 3, 33.3%; p = .03). Somatic comorbidity was a significant coefficient in a multivariate survival model (B = 2.32, p = .04).ConclusionSomatic comorbidity seems to be an important factor for anorexia nervosa outcome and should be included in multivariate analyses on the long-term course of anorexia nervosa as an independent variable. Further investigations are needed in order to understand in which way anorexia nervosa and a somatic disease can interact.

Suffering in long-term cancer survivors: An evaluation of the PRISM-R2 in a population-based cohort

PurposeThe Pictorial Representation of Illness and Self Measure-Revised 2 (PRISM-R2) has been developed as generic measure to assess suffering. The aim of this study was to evaluate the ability of this instrument to identify long-term cancer survivors with high levels of suffering who may need additional support.Methods1299 cancer survivors completed the PRISM-R2, the Short Form Health Survey (SF-36), and the Quality of Life-Cancer Survivors questionnaire (QoL-CS). The PRISM-R2 distinguishes between the Self-Illness Separation (SIS) and Illness Perception Measure (IPM), both measuring aspects of suffering.Results112 (9%) cancer survivors reported high suffering according to IPM. This group had a higher cancer stage at diagnosis, more cancer recurrences, more comorbidities, and were lower educated compared to people reporting less suffering. The PRISM-R2 could explain substantial amounts of variance (10–14%) in the psychological aspects of the SF-36 and QoL-CS. The IPM also discriminated statistically and clinically significant between high- and low-health status.ConclusionThe PRISM-R2 proved to be able to discriminate between individuals with good and deteriorated levels of QoL. Further evaluation of its validity and screening potential is recommended.

Validation of the turkish version of the centre for epidemiologic studies depression scale (ces-d) in patients with type 2 diabetes mellitus

BackgroundDepression is a common co-morbid health problem in patients with diabetes that is underrecognised. Current international guidelines recommend screening for depression in patients with diabetes. Yet, few depression screening instruments have been validated for use in this particular group of patients. Aim of the present study was to investigate the psychometric properties of the Turkish version of the Centre for Epidemiologic Studies Depression Scale (CES-D) in patients with type 2 diabetes.MethodsA sample of 151 Turkish outpatients with type 2 diabetes completed the CES-D, the World Health Organization-Five Well-Being Index (WHO-5), and the Problem Areas in Diabetes scale (PAID). Explanatory factor analyses, various correlations and Cronbachs alpha were investigated to test the validity and reliability of the CES-D in Turkish diabetes outpatients.ResultsThe original four-factor structure proposed by Radloff was not confirmed. Explanatory factor analyses revealed a two-factor structure representing two subscales: (1) depressed mood combined with somatic symptoms of depression and (2) positive affect. However, one item showed insufficient factor loadings. Cronbachs alpha of the total score was high (0.88), as were split-half coefficients (0.77-0.90). The correlation of the CES-D with the WHO-5 was the strongest (r = -0.70), and supported concurrent validity.ConclusionThe CES-D appears to be a valid measure for the assessment of depression in Turkish diabetes patients. Future studies should investigate its sensitivity and specificity as well as test-retest reliability.

Body image in cancer survivors: a systematic review of case-control studies.

PurposeThere is common consensus that cancer and its treatment can impair the body, but combined evidence of the previous literature in cancer survivors is missing. Therefore, we reviewed body image in cancer survivors and focused on case-control studies, in order to draw conclusions as to whether body image might be altered due to cancer.MethodsMedline, Cinahl, Embase, and PsycInfo were searched and after duplicate extraction, 1932 hits were retrieved and screened for eligibility. Included studies were rated on selection, measurement, and reporting bias.ResultsTwenty-five studies were identified using 19 different scales to measure body image. Ten studies reported a more negative body image in survivors, nine found no differences, three reported mixed findings, and three reported a more positive body image in survivors. Potential bias was common and 16 studies had at least three sources of potential bias. Less-biased studies (i.e., ≤2 sources of bias) hinted to weak differences between survivors and controls, favoring healthy controls. A meta-analysis could not be performed.ConclusionsThis review was long overdue and indicates a somewhat more negative body image in cancer survivors than healthy controls. However, numerous problems potentially biasing study results have been detected and firm conclusions cannot be drawn.Implications for Cancer SurvivorsFuture studies should recruit larger samples, match samples, and pay attention to how body image is conceptualized and measured in order to draw reliable conclusions as to whether body image is impaired in cancer survivors.

Fertility perspectives and priorities among male adolescents and young adults in cancer survivorship

Infertility is a common and distressing late effect of cancer treatment among male survivors. Investigators examined desire for parenthood, prioritization of fertility compared to other life goals, and reports of fertility‐related discussions among a cohort of male adolescent and young adult survivors. Eighty percent desired a biological child, yet only 31% ranked having a child among their “top 3” life goals. Only 40% reported fertility‐related discussions with their health care providers in survivorship. Given the importance of biological children among this cohort, future guidelines should encourage a more proactive approach to providing fertility counseling and offering testing, to mitigate distress and prevent unplanned pregnancies.

Psychosexual development and satisfaction in long-term survivors of childhood cancer: Neurotoxic treatment intensity as a risk indicator

Risk factors for impairment in psychosexual development and satisfaction among adult survivors of childhood cancer are poorly understood. The authors compared psychosexual outcomes between survivors and healthy controls, and tested whether at‐risk survivors can be identified by 1) treatment neurotoxicity or 2) diagnosis.

The Impact of Pediatric Cancer on the Family

The diagnosis of childhood cancer is a significant stressor that can affect the psychosocial well-being of family members and their interactions with one another from diagnosis, through treatment, to survivorship and/or end of life. Consideration of the impact of cancer in the context of the family system is critical. Many families adjust well after the initial disruption following diagnosis and initiation of treatment. However, there may be increased risk for parent distress, particularly among mothers. Negative effects on family relationships and individual adjustment are also evident for parents and siblings who are bereaved. Supportive care of the family should be multidisciplinary and evidence based to address information needs, decision making, adjustment, and long-term challenges into survivorship or after a child’s death. Implications for future research are highlighted.