Trajectories of psychological distress in adolescent and young adult patients with cancer

a 1-year longitudinal study.

Minyoung Kwak, Brad J. Zebrack, Kathleen A. Meeske, Leanne Embry, Christine Aguilar, Rebecca Block, Brandon Hayes-Lattin, Yun Li, Melissa Butler, Steven Cole

Research output: Contribution to journalArticle

83 Citations (Scopus)

Abstract

To examine prevalence and changes in symptoms of psychological distress over 1 year after initial cancer diagnosis in adolescent and young adult (AYA) patients with cancer. Sociodemographic and clinical predictors of changes in distress were examined. In this multisite, longitudinal, prospective study of an ethnically diverse sample, 215 patients age 14 to 39 years were assessed for psychological distress within the first 4 months of diagnosis and again 6 and 12 months later. Linear mixed models with random intercept and slope estimated changes in distress, as measured by the Brief Symptom Inventory-18 (BSI-18). Within the first 4 months of diagnosis, 60 respondents (28%) had BSI-18 scores suggesting caseness for distress. On average, distress symptoms exceeded population norms at the time of diagnosis, dipped at the 6-month follow-up, but increased to a level exceeding population norms at the 12-month follow-up. A statistically significant decline in distress over 1 year was observed; however, the gradient of change was not clinically significant. Multivariate analyses revealed that the reduction in distress over time was primarily a function of being off treatment and involved in school or work. Notably, cancer type or severity was not associated with distress. Findings emphasize the importance of early psychosocial intervention for distress in AYAs as well as the need to manage treatment-related symptoms and facilitate AYAs' involvement in work or school to the extent possible. Continued research is needed to understand how distress relates to quality of life, functional outcomes, treatment, and symptom burden throughout the continuum of care.

Original languageEnglish (US)
Pages (from-to)2160-2166
Number of pages7
JournalJournal of clinical oncology : official journal of the American Society of Clinical Oncology
Volume31
Issue number17
StatePublished - Jun 10 2013

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Longitudinal Studies
Young Adult
Psychology
Neoplasms
Equipment and Supplies
Continuity of Patient Care
Population
Linear Models
Multivariate Analysis
Quality of Life
Prospective Studies
Therapeutics
Research

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Trajectories of psychological distress in adolescent and young adult patients with cancer : a 1-year longitudinal study. / Kwak, Minyoung; Zebrack, Brad J.; Meeske, Kathleen A.; Embry, Leanne; Aguilar, Christine; Block, Rebecca; Hayes-Lattin, Brandon; Li, Yun; Butler, Melissa; Cole, Steven.

In: Journal of clinical oncology : official journal of the American Society of Clinical Oncology, Vol. 31, No. 17, 10.06.2013, p. 2160-2166.

Research output: Contribution to journalArticle

Kwak, Minyoung ; Zebrack, Brad J. ; Meeske, Kathleen A. ; Embry, Leanne ; Aguilar, Christine ; Block, Rebecca ; Hayes-Lattin, Brandon ; Li, Yun ; Butler, Melissa ; Cole, Steven. / Trajectories of psychological distress in adolescent and young adult patients with cancer : a 1-year longitudinal study. In: Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2013 ; Vol. 31, No. 17. pp. 2160-2166.
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