Adolescents and young adults (AYAs) with cancer are a unique population of patients who experience a period of intense and dramatic life changes when they are diagnosed. Overall, AYAs with cancer are resilient; however, their psychosocial needs are often underestimated or unmet. Currently, there are inconsistencies in how AYAs are screened and treated for anxiety and depression. Barriers to treatment include clinicians’ lack of confidence in distinguishing between side effects of treatment and depression/anxiety. Additional barriers include the black box warning for prescribing antidepressants and difficulty partnering with mental health professionals. This article seeks to provide recommendations for pediatric oncology clinicians on how to identify and address anxiety and depression in AYAs and how to partner with mental health professionals in their treatment, and it suggests directions for future research.
AbramsA. N.HazenE. P.PensonR. T. (2007). Psychosocial issues in adolescents with cancer. Cancer Treatment Review, 33(7), 622-630.
2.
ApterA.FarbsteinI.YanivI. (2003). Psychiatric aspects of pediatric cancer. Clinical Journal of Child and Adolescent Psychiatry, 12(7), 473-492.
3.
BellizziK. M.SmithA.SchmidtS.KeeganT. H.ZebrackB.LynchC. F.. . . SimonM. (2012). Positive and negative psychosocial impact of being diagnosed with cancer as an adolescent or young adult. Cancer, 118(20), 5155-5162.
CocciaP. F.AltmanJ.BathiaS.BorinsteinS. C.FlynnJ.GeorgeS.. . . SheadD. A. (2012). Adolescent and young adult oncology: Clinical practice guidelines in oncology. Journal of the National Comprehensive Cancer Network, 10(9), 1112-1150.
6.
DysonG. J.ThompsonK.PalmerS.ThomasD. M.SchofieldP. (2011). The relationship between unmet needs and distress amongst young people with cancer. Supportive Care in Cancer, 20(1), 75-85.
7.
EpelmanC. L. (2013). The adolescent and young adult with cancer: State of the art psychosocial aspects. Current Oncology Reports, 15, 325-331.
8.
EriksonE. (1963) Childhood and society (2nd ed.). New York: W.W. Norton.
9.
FischM. (2004). Treatment of depression in cancer. Journal of the National Cancer Institute. Monographs, (32), 105-111.
10.
HedstromM.KreugerA.LjungmanG.NygrenP.von EssenL. (2006). Accuracy of assessment of distress, anxiety, and depression by physicians and nurses in adolescents recently diagnosed with cancer. Pediatric Blood & Cancer, 46(7), 773-779.
11.
KazakA.BarakatL.DitarantoS.BirosD.HwangW.BeeleD.. . .ReillyA. (2011). Screening for psychosocial risk at pediatric cancer diagnosis: The Psychosocial Assessment Tool. Journal of Pediatric Hematology/Oncology, 33(4), 289-294.
12.
KersunL. S.KazakA.E. (2006). Prescribing practices of selective serotonin reuptake inhibitors (SSRIs) among pediatric oncologists: A single institution experience. Pediatric Blood & Cancer, 47(3), 339-342.
13.
KersunL. S.RourkeM. T.MickleyM.KazakA. E. (2009). Screening for depression and anxiety in adolescent cancer patients. Journal of Pediatric Hematology and Oncology, 31(11), 835-839.
14.
KurtzB. P.AbramsA. N. (2011). Psychiatric aspects of pediatric cancer. Pediatric Clinics of North America, 58(4), 1003-1023.
15.
LibbyA. M.BrentD.MorratoE. H.OrtonH. D.AllenR.ValuckR. J. (2007). Decline in treatment of pediatric depression after FDA advisory on risk of suicidality with SSRIs. American Journal of Psychiatry, 164(6), 884-891.
16.
MorganS.DaviesS.PalmerS.PlasterM. (2010). Sex, drugs, and rock ‘n’ roll: Caring for adolescents and your adults with cancer. Journal of Clinical Oncology, 28(32), 4825-4830.
17.
MyersR. M.BalsamoL.XiaominL.MeenakshiD.HungerS. P.CarrollW. L.. . . Kadan-LottickN. S. (2014). A prospective study of anxiety, depression, and behavioral changes in the first year after a diagnosis of childhood acute lymphoblastic leukemia: A report from the Children’s Oncology Group. Cancer, 3(1), 1-9.
18.
PaoM.BallardE. D.RosenteinD. L.WienerL.WayneA. S. (2006). Psychotropic medication use in pediatric patients with cancer. Archives of Pediatrics & Adolescent Medicine, 160(8), 818-22.
19.
PhippsS.BuckholdtK. E.FernandezL.WienerL.KupstM. J.Madan-SwainA.. . . NollR. B. (2012). Pediatric oncologists’ practices of prescribing selective serotonin reuptake inhibitors (SSRIs) for children and adolescents with cancer: A multi-site study. Pediatric Blood & Cancer, 58(2), 210-215.
20.
PortteusA.AhmadN.TobeyD.LeavyP. (2006). The prevalence and use of antidepressant medication in pediatric cancer patients. Journal of Child and Adolescent Psychopharmacology, 16(4), 467-73.
21.
SmithA. W.BellizziK. M.KeeganT. H.ZebrackB.ChenV. W.NealeA. V.. . . LynchC. F. (2013). Health-related quality of life of adolescent and young adult patients with cancer in the United States: The Adolescent and Young Adult Health Outcomes and Patient Experience study. Journal of Clinical Oncology, 31(17), 2136-2145.
22.
SzaldaD.BrumleyL. D.DanielsonC. K.SchwartzL. A. (2013). Exploratory analyses of substance use in adolescents with and without cancer. Journal of Adolescent and Young Adult Oncology, 2(2), 77-82.
23.
ThompsonK.DysonG.HollandL.JoubertL. (2013). An exploratory study of oncology specialists’ understanding of the preferences of young people living with cancer. Social Work Health Care, 52(3), 166-190.
24.
ZebrackB.BlockR.Hayes-LattinB.EmbryL.AguilarC.MeeskeK. A.. . . ColeS. (2013). Psychosocial service use and unmet need among recently diagnosed adolescent and young adult cancer patients. Cancer, 119(1), 201-214.
