Background:
Adolescents and Young Adults with Cancer (AYAC) face unique psychosocial challenges. Literature repots state that up to 29% experience depression and 21% anxiety. In low- and middle-income countries (LMICs), there is a dearth of longitudinal data on distress trajectories following psycho-oncology referral of AYAC. We studied how psychological distress evolved in AYAC over one year of follow-up after initial psycho-oncology assessment.
Methods:
We conducted a prospective, single-arm, single-center observational study at our psycho-oncology service in a tertiary cancer center. AYAC of age 15-39 years, receiving disease-directed or supportive care and referred to our service, able to consent, and comprehending Hindi or Marathi were included for the study. They were assessed at baseline and at 3, 6, 9, and 12 months using the Generalized Anxiety Disorder-7 (GAD-7) scale. Standard psychosocial interventions were delivered according to clinical need. Descriptive and inferential statistics were used to evaluate changes and correlates of distress.
Results:
Data of 150 participants followed up for 9 months were analysed for this study. The mean age was 26.6y (SD 7.1), with 81 males (54%) and 79 outpatients (53%). Anxiety symptoms ranging from mild to severe were seen in 66 patients (44%). exhibited significant anxiety at baseline. Distress decreased significantly by 3 months and plateaued thereafter. Fatigue and depressive symptoms moderately correlated with anxiety levels at baseline. Age above 24 years was associated with distress at 3 and 9 months and education level at 3 months. Multimodal psychosocial interventions were commonly employed. Challenges included attrition and data loss due to illness or mortality.
Conclusions:
Distress in AYAC is highest at initial referral and may improve with early psycho-oncology support. These findings reinforce the need for tailoring context driven integrated, multidisciplinary, and age-specific psycho-oncology care in low-resource settings in LMICs.