Identifying Major Depressive Symptoms and Major Depressive Episodes in Adolescents with Cancer

• Author / Creator

  Lee, Anra

• Cancer is the leading cause of death from disease among adolescents in Canada. Although cancer is a well-researched disease process in the medical and nursing literature, adolescence is relatively understudied, with minimal evidence on strategies to promote healthy emotional adjustment throughout the disease trajectory. Current literature on major depressive episodes (MDE) in adolescents diagnosed with cancer suggests limited evidence in screening and diagnosing MDEs. Furthermore, current practice in pediatric oncology centres do not include routine psychosocial assessments of adolescents with cancer, but rather, rely on individual clinician discretion on individuals who may benefit from referrals to a psychosocial and/or psychiatric team. Existing instruments used to screen for depression in adolescents have not previously been tested for clinical utility in pediatric oncology patients, which is problematic due to the significant overlap in MDE symptoms and adverse side effects of cancer disease and treatment. Research on adult cancer survivors suggests that age, gender, and anxiety are significantly related to depression, but this has not previously been examined among Canadian adolescent cancer patients.
  This study employed a cross-sectional descriptive design to examine and compare the feasibility of utilizing the Children’s Depression Inventory (CDI) and the Diagnostic Interview for Children and Adolescents (DICA-IV) to screen for MDEs, and to examine the relationships among age, gender, and anxiety and a MDE in adolescents with cancer. Of the twenty five eligible participants, fourteen adolescent patients with either a malignant cancer or tumour requiring chemotherapy treatment or a hematological disorder requiring a blood or bone marrow transplant were recruited from an outpatient pediatric oncology clinic. The CDI was found to be a feasible tool that can be used in busy clinical settings, as it was less time-intensive compared to the DICA-IV. Further comparison of the CDI and DICA-IV indicated that there was no evidence that participants were more willing to disclose their symptoms on a self-report questionnaire compared to a face-to-face interview. As for recruitment issues, females were more willing to participate in the study than males, but overall, adolescents as a group were a difficult population to engage in the study, with only a 56% participation rate in this study. Future research will need to address these recruitment challenges. Finally gender (p=0.013) and anxiety (p=0.003) were significantly correlated with a MDE.

• Subjects / Keywords

  • Depression
  • Psychosocial
  • Cancer
  • Anxiety
  • Oncology
  • Mental health
  • Diagnosing
  • Screening
  • Adolescents
  • Pediatrics

• Graduation date

  Fall 2015

• Type of Item

  Thesis

• Degree

  Master of Nursing

• DOI

  https://doi.org/10.7939/R3R20S472

• License

  This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.