Risk factors for suicidal ideation in a large, registry-based sample of adult long-term childhood cancer survivors

• Published in: Journal of affective disorders Vol. 265; pp. 351 - 356
• Main Authors: Ernst, Mareike, Brähler, Elmar, Wild, Philipp S., Jünger, Claus, Faber, Jörg, Schneider, Astrid, Beutel, Manfred E.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 15.03.2020
• Subjects: Adult; Cancer; Cancer Survivors; Cancer survivorship; Child; Cross-Sectional Studies; Humans; Neoplasms - epidemiology; Protective factors; Registries; Risk Factors; Suicidal Ideation; Suicide; Protective factors; Suicidal ideation; Suicide; Risk factors; Cancer; Cancer survivorship
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2020.01.080

•8% of adult survivors of childhood cancer reported suicidal ideation.•Survivors of CNS tumors are an especially vulnerable group.•Past suicide attempts and current distress were associated with suicidal ideation.•Loneliness and living alone were related to suicidal ideation in cancer survivors.•Common late effects of cancer co-occurred with suicidal ideation. Long-term childhood cancer survivors (CCS) are at risk for physical and psychosocial late effects. Previous research has attested to increased rates of suicidal ideation (SI) in CCS, an especially dangerous indicator of distress. However, little was known about risk factors of SI among CCS which go beyond illness- and treatment related variables. A registry-based sample of 916 adult long-term CCS (Mage=34.58 years [SD=5.53], Mage at diagnosis=6.15 years [SD=4.28]) underwent medical assessments and filled out questionnaires. We conducted a linear regression analysis on SI, testing predictors of different areas: sociodemographic, social, physical health and health behavior, and psychological distress symptoms. SI was reported by 73 (8.0%) CCS and previous suicide attempts were reported by 26 (2.8%) CCS. SI was most closely related to social and psychological factors, i.e. to concurrent distress symptoms (depression, anxiety, social phobia), previous suicide attempts, current loneliness, and the present living situation. SI and previous suicide attempts were assessed using short self-report instruments. The cross-sectional study design does not allow for causal inferences. Long-term CCS are a previously understudied, vulnerable group. Decades after having survived cancer, a considerable percentage is affected by (recurrent) SI. CCS’ risk for SI is likely shaped by individual medical and psychological history, and by the current social environment and psychological comorbidities. There is a need for more interdisciplinary research and for screening efforts which take account of these factors. Interventions reducing CCS’ risk of suicide should foster social integration and counteract current stressors.