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Loneliness predicts suicidal ideation and anxiety symptoms in long-term childhood cancer survivors
Authors:Mareike Ernst  Elmar Brähler  Philipp S. Wild  Jörg Faber  Hiltrud Merzenich  Manfred E. Beutel
Affiliation:1. Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Germany;2. Preventive Cardiology and Preventive Medicine-Department of Cardiology, University Medical Center Mainz, Germany;3. Center for Thrombosis and Hemostasis, University Medical Center Mainz, Germany;4. DZHK German Center for Cardiovascular Research, Partner Site Rhine-Main, Mainz, Germany;5. Department of Pediatric Hematology/Oncology/Hemostaseology, Center for Pediatric and Adolescent Medicine, University Medical Center Mainz, Germany;6. Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center Mainz, Germany
Abstract:Background/ObjectiveLong-term childhood cancer survivors (CCS) are at risk for adverse late effects. However, not all of them are well understood. The present study addressed loneliness, a previously under-researched mental health risk in cancer survivor populations. We assessed the prevalence of loneliness and its impact on psychological symptoms over time. Method: A registry-based sample of N = 633 adult long-term CCS underwent medical and psychological assessments and took part in a follow-up survey 2.5 years later. Psychological symptoms (somatic, anxiety, depression symptoms, and suicidal ideation) were measured using the Patient Health Questionnaire. We calculated linear regression models of symptoms at follow-up to investigate the impact of loneliness over time (controlling for symptoms at baseline and relevant confounders). Results: Loneliness was reported by 17.70% of CCS. In multivariate linear regression analyses, loneliness was still predictive of more severe anxiety symptoms and suicidal ideation over two years later. Loneliness did not predict somatic and depression symptoms at follow-up (which increased with age). Conclusions: Loneliness affected a significant number of CCS and was a risk factor for persistent anxiety symptoms and suicidal ideation. The extent to which young cancer patients’ re-integration into society is successful could thus have important implications for well-being in adulthood.
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