Psychological distress and resilience in a multicentre sample of adolescents and young adults with cancer during the COVID-19 pandemic

  1. Clare Jacobson
  2. Nicola Miller
  3. Rebecca Mulholland
  4. Laura Baker
  5. Daniel Glazer
  6. Emily Betts
  7. Louise Brown
  8. Vera Elders
  9. Robert Carr
  10. Olufunmilola Ogundiran
  11. Lee D Hudson

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Abstract

Understanding impact of the coronavirus pandemic (COVID-19) on Adolescents and Young Adults (AYA) with cancer is important to inform care. Online survey of 16–24 year olds receiving cancer treatment at eight cancer centres in the UK. We measured: self-perceived increased anxiety since COVID-19, impact of COVID-19 on treatment, life and relationships, PHQ-8, GAD and the two-item Connor–Davidson Resilience Scale (CD-RISC). 112 AYA participated. 59.8% had previous mental health difficulties. 78.6% reported COVID-19 having a significant impact on life. 79% reported experiencing increased anxiety since COVID-19.43.4% had moderate-severe PHQ-8 scores and 37.1% GADS-7 scores. Impact on life was associated with moderate-severe PHQ-8 scores (OR 5.23, 95% CI 1.65–16.56, p < 0.01), impact on relationships with moderate-severe GADS-7 and PHQ-8 score (OR 2.89, 95% CI 1.11–7.54, p = 0,03; OR 3.54, 95% CI 2.32–15.17, p < 0.01; OR 2.42, 95% CI 1.11–5.25, p =0.03). Greater resilience was associated with lower mod-severe GADS-7and PHQ-8 scores (OR 0.58, 95% CI 0.41–0.81, p < 0.01; OR 0.55 95% CI 0.4–0.72, p < 0.01; OR 0.52, 95% CI 0.38–0.69, p < 0.01). We found high levels of psychological distress. Perceived impact of COVID-19 on relationships and life was predictive of poorer mental health, with resilience a protective factor.

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  1. Version published to 10.1177/13591045211056923
  2. ScreenIT

    SciScore for 10.1101/2021.03.29.21254529: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Analyses were conducted using STATA (version 16).
    STATA
    suggested: (Stata, RRID:SCR_012763)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Our study has a number of strengths and limitations. We used validated psychological questionnaires, alongside pragmatic questions to identify specific perceived impacts during COVID-19. There were a greater proportion of females in our sample and age group predominance was disproportionate (with the majority being aged 22-24). However, we deliberately recruited up to the age of 30 because whilst we were interested in AYA patients (16-24) we did not want to exclude data from patients who were diagnosed in this age group but continued treatment for a longer period or had relapsed. The proportion of AYA who reported being eligible for free school meals is similar to nationally reported rates (13.6% in England[27]), suggesting representativeness of socio-economic status of the total population. We did not formally power our sample size, with the aim of recruiting as many AYA as possible. Though we recruited from 8 centres and targeted all eligible patients within those centres, our sample is small and less than 20% of eligible patients. This might have meant that our sample was not adequately powered to detect small effect sizes in univariable logistic regression models. The sample size also potentially leads to bias, in particular because AYA with higher levels of psychological difficulties may have been motivated to take part. Our sample is also cross-sectional and associations we have reported do not imply causation. Similarly, reported psychological measures may not have bee...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  3. Version published to 10.1101/2021.03.29.21254529v2 on medRxiv
  4. Version published to 10.1101/2021.03.29.21254529v1 on medRxiv