Objective: This study examines the differential association between sex and depression, and the possible mediating pathways.
Methods: We analysed survey data from 296 (age 7-17.1 years) cancer survivors from three centres affiliated with Beijing Children's Hospital. Linear regression analysis was used to assess the association between sex and depression. Quantile regression analysis was used to estimate the regression coefficients (β) and 95% confidence intervals for sex in depression at different quantiles. Mediation analysis with multiple mediators was used to explore the effects of sex on depression.
Results: Using linear regression, we found that the age ranged from 8.7 to 10.4 years and the regression coefficient of sex on depression was significant (β = -2.75, p = 0.03). Quantile regression results showed a significant negative association between sex and depression in the 0.30-0.75 quantiles. Mediation analysis revealed that boys were 1.545 times more depressed than girls, with family resilience, self-perceived burden, and behavioural problems explaining approximately 16.79%, 21.57%, and 43.94% of the sex difference, respectively. The combined effect of family functioning, resilience, social support, self-perceived burden, and behavioural problems might explain the 89.17% sex difference.
Conclusion: Clinicians should consider sex effects when assessing depression in childhood cancer survivors and target sex-specific interventions for further treatment.
Keywords: cancer; childhood cancer survivors; depression; oncology; sex differences.
© 2022 John Wiley & Sons Ltd.