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PEDIATRICS Vol. 113 No. 6 June 2004, pp. 1700-1708

Anxiety, Depressive, and Posttraumatic Stress Disorders Among Mothers of Pediatric Survivors of Hematopoietic Stem Cell Transplantation

Sharon Manne, PhD*, Katherine DuHamel, PhD{ddagger}, Jamie Ostroff, PhD§, Susan Parsons, MD||, D. Richard Martini, MD, Sharon E. Williams, PhD#, Laura Mee, PhD**, Sandra Sexson, MD**, Jane Austin, PhD{ddagger}, Joanne Difede, PhD{ddagger}{ddagger}, Christine Rini, PhD{ddagger}, William H. Redd, PhD{ddagger}

* Fox Chase Cancer Center, Philadelphia, Pennsylvania
{ddagger} Ruttenberg Cancer Center, Mount Sinai School of Medicine, New York, New York
§ Memorial Sloan-Kettering Cancer Center, New York, New York
|| Dana-Farber Cancer Institute and Children’s Hospital, Boston, Massachusetts
Children’s Memorial Hospital, Northwestern University Medical School, Chicago, Illinois
# Packard Children’s Hospital, Stanford University Medical School, Palo Alto, California
** Emory University School of Medicine, Atlanta, Georgia
{ddagger}{ddagger} Cornell University School of Medicine, New York, New York

Objective. To examine the prevalence and predictors of anxiety, depression, and posttraumatic stress disorder among mothers of children who underwent hematopoietic stem cell transplantation (HSCT).

Methods. A total of 111 mothers of children who survived HSCT completed self-report measures of psychological functioning at the time of HSCT and self-report measures and a structured psychiatric interview 18 months after HSCT. Demographic data and medical data were also collected.

Results. Approximately 20% of mothers had clinically significant distress reactions. When subthreshold posttraumatic stress disorder was included, nearly one third of mothers met the criterion for persistent distress. Mothers with 1 of the 4 psychiatric diagnoses reported a significantly lower quality of life, suggesting that the diagnoses had an impact on their general quality of life. Mothers who had 1 of the 4 diagnoses at 18 months were younger and had higher anxiety and depressive symptoms at the time of HSCT.

Conclusions. A subset of mothers of children who survive HSCT may require psychological intervention. Mothers who are most at risk are younger and evidence anxiety and depressive symptoms at the time of transplantation.

Key Words: stem cell transplantation • maternal distress • childhood cancer survivors

Abbreviations: HSCT, hematopoietic stem cell transplantation • GvHD, graft-versus-host disease • GAD, generalized anxiety disorder • MDD, major depressive disorder • PD, panic disorder • PTSD, posttraumatic stress disorder • SCID-NP, Structured Clinical Interview for DSM-IV, NonPatient Version • IES, Impact of Events Scale • BAI, Beck Anxiety Inventory • BDI, Beck Depression Inventory

Received for publication Aug 4, 2003; Accepted Oct 15, 2003.


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