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Psychiatric disorders among children of parents with cancer: a Swedish register-based matched cohort study
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Centre for Psychiatry Research & Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
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2018 (English)In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 27, no 7, p. 1854-1860Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To investigate the risk of psychiatric disorders among children of parents with cancer in a nationwide population-based setting.

METHODS: Based on Swedish national registers, the study included 101,339 children with parental cancer diagnosed either during pregnancy (N=1,047) or after birth (N=100,292) that were born during 1983-2000. For each exposed child, we randomly selected 10 unexposed children from the general population after individual matching by year of birth and sex. The matched cohort was followed during 2001-2010. Clinical diagnoses of psychiatric disorders and use of prescribed psychiatric medications were identified for all children. Cox regression and logistic regression were used to evaluate the associations of parental cancer with psychiatric disorder diagnosis and psychiatric medication use respectively.

RESULTS: Parental cancer during pregnancy was not associated with the risk of psychiatric disorders overall, although paternal cancer during pregnancy was associated with a higher risk of psychiatric medication use among females. Parental cancer after birth was associated with higher risks of psychiatric disorder diagnoses, particularly stress reaction and adjustment disorders (males:hazard ratio[HR]:1.24, 95% confidence interval[CI]:1.08-1.43; females:HR:1.27, 95%CI:1.14-1.41), and use of psychiatric medication (males:odds ratio[OR]:1.09, 95%CI:1.04-1.13;females:OR:1.14, 95%CI:1.10-1.18). The positive associations were stronger for parental cancer with poor expected survival and for parental death after cancer diagnosis.

CONCLUSIONS: Parental cancer, primarily the life-threatening cancer, might confer a higher risk of psychiatric disorders among children. These findings have potential implications for healthcare professionals in providing targeted support to children living with a parent with cancer.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018. Vol. 27, no 7, p. 1854-1860
Keywords [en]
Cancer, Child of impaired parents, Cohort study, Mental disorders, Oncology
National Category
Psychiatry Cancer and Oncology
Identifiers
URN: urn:nbn:se:oru:diva-66710DOI: 10.1002/pon.4738ISI: 000438361200023PubMedID: 29663601OAI: oai:DiVA.org:oru-66710DiVA, id: diva2:1200219
Funder
Swedish Cancer Society, CAN2014/417Forte, Swedish Research Council for Health, Working Life and Welfare, 2012-0498The Karolinska Institutet's Research Foundation
Note

Funding Agency:

China Scholarship Council  201206100002

Available from: 2018-04-23 Created: 2018-04-23 Last updated: 2018-08-02Bibliographically approved

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Fall, Katja

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