Prevalence of mental distress among adult survivors of childhood cancer in Germany-Compared to the general population

Juliane Burghardt, Eva Klein, Elmar Brähler, Mareike Ernst, Astrid Schneider, Susan Eckerle, Marie Astrid Neu, Arthur Wingerter, Nicole Henninger, Marina Panova-Noeva, Jürgen Prochaska, Philipp Wild, Manfred Beutel, Jörg Faber

Research output: Journal article (peer-reviewed)Journal article

25 Citations (Scopus)


BACKGROUND: Increasing survival rates after childhood cancer have raised the issue of long-term mental health consequences in adulthood. This study determines mental health distress among long-term survivors of pediatric cancer and compares it to control groups.

METHODS: Childhood cancer survivors (CCS; N = 951, aged 24-49 years) were compared to three age-matched control groups from the general population collected at three time points. The study compared the prevalence of clinically relevant symptoms of a wide range of common mental disorders (depression, somatic distress, suicidal ideation, generalized anxiety, panic, social anxiety, and sleep disturbances) using identical, validated questionnaires. CCS were identified by the German Childhood Cancer Registry. Controls were approached by a demographic consultation company (USUMA) which assured that the three samples were nationally representative.

RESULTS: Childhood cancer survivors reported higher education than controls and were less often married. All forms of common mental distress were increased among survivors. Twenty-four percent of male (N = 526) and 41% of female survivors (N = 425) reported some form of clinically relevant mental health symptoms. Somatic distress as the leading complaint was highly frequent among CCS (OR: 10.98, CI 95%: 7.24-16.64). Complaints by generalized anxiety (OR: 5.04, CI 95%: 2.61-9.70), panic (OR: 3.28, CI 95%: 1.60-6.70), depression (OR: 3.36, CI 95%: 2.22-5.09), and suicidality (OR = 2.22; CI 95%: 1.38-3.57) were also strongly increased. Female sex, low education, low income, and unemployment were associated with increased distress.

CONCLUSIONS: Findings indicate a need to integrate psycho-oncological screening and care into long-term aftercare. Somatic distress, as cause and indicator of psychological distress, should receive stronger attention, especially tiredness, low energy, and pain.

Original languageEnglish
Pages (from-to)1865-1874
Number of pages10
JournalCancer Medicine
Issue number4
Publication statusPublished - Apr 2019
Externally publishedYes


  • Adult
  • Cancer Survivors/psychology
  • Case-Control Studies
  • Female
  • Germany/epidemiology
  • Humans
  • Male
  • Marital Status/statistics & numerical data
  • Mental Disorders/epidemiology
  • Middle Aged
  • Prevalence
  • Registries
  • Sex Factors
  • Socioeconomic Factors
  • Stress, Psychological/epidemiology
  • Young Adult


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