Risk factors for psychological and psychosomatic symptoms among children with malignancies

J Paediatr Child Health. 2018 Apr;54(4):411-415. doi: 10.1111/jpc.13771. Epub 2017 Nov 3.

Abstract

Aim: With increasing survival rates in paediatric malignancies, the quality-of-life of children during hospitalisation should be given more attention. We aimed to identify factors associated with psychological and psychosomatic symptoms (PPS) that required medication among children hospitalised for treatment of malignancies.

Methods: We retrospectively analysed data of 190 patients aged 2-18 years old. They were diagnosed with malignant diseases and admitted for treatment at St. Luke's International Hospital between 2003 and 2013. Patients were considered as having PPS if they were prescribed psychotropic agents during hospitalisation.

Results: Of the 190 patients, 56 (30%) were prescribed psychotropic agents for PPS. Types of PPS included insomnia in 21 (38%), anxiety in 11 (20%), and others conditions (psychogenetic nausea, agitation, delirium, depression). The most prescribed psychotropic agents were etizolam for 34 cases (61%), followed by diazepam and risperidone. The multivariable analyses confirmed statistically significant independent associations for haematopoietic stem cell transplantation (HSCT) (odds ratio (OR), 5.21; 95% confidence interval (CI), 1.77-15.35), older age (12-18 years vs. 2-5 years, OR, 3.74; 95% CI, 1.04-10.00), and opioid use (OR, 7.15; 95% CI, 2.36-21.69).

Conclusions: Older age at admission, undergoing HSCT, and those given opioids were found to be risk factors for PPS among children with malignancies. Appropriate preventive measures against PPS may be warranted for patients with these risk factors.

Keywords: childhood cancer; haematopoietic stem cell transplantation; psychological and psychosomatic symptom.

MeSH terms

  • Adolescent
  • Age Factors
  • Analgesics, Opioid / therapeutic use*
  • Anxiety Disorders / drug therapy
  • Anxiety Disorders / etiology*
  • Child
  • Child, Preschool
  • Depression / drug therapy
  • Depression / etiology
  • Female
  • Hematopoietic Stem Cell Transplantation / psychology*
  • Humans
  • Male
  • Multivariate Analysis
  • Neoplasms / psychology*
  • Neoplasms / therapy
  • Psychophysiologic Disorders / drug therapy
  • Psychophysiologic Disorders / etiology*
  • Psychotropic Drugs / therapeutic use*
  • Retrospective Studies
  • Risk Factors
  • Sleep Initiation and Maintenance Disorders / drug therapy
  • Sleep Initiation and Maintenance Disorders / etiology*

Substances

  • Analgesics, Opioid
  • Psychotropic Drugs