Depression, Anxiety, and Stress in Parents of Patients With Retinoblastoma

• Published in: American journal of ophthalmology 2019-11, Vol.207, p.130-143
• Main Authors: Collins, Mary Louise Z., Bregman, Jana, Ford, Jennifer S., Shields, Carol L.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Anxiety; Anxiety - epidemiology; Anxiety - etiology; Anxiety - psychology; Cancer; Cancer therapies; Children & youth; Chronic illnesses; Cross-Sectional Studies; Depression - epidemiology; Depression - etiology; Depression - psychology; Families & family life; Female; Guardians; Humans; Hypotheses; Male; Middle Aged; Mortality; Mutation; Ophthalmology; Parent-Child Relations; Parents & parenting; Parents - psychology; Patients; Radiation therapy; Retina; Retinal Neoplasms - psychology; Retinoblastoma; Retinoblastoma - psychology; Self Report; Stress; Stress, Psychological - epidemiology; Stress, Psychological - etiology; Stress, Psychological - psychology; Surveys and Questionnaires; Tumors; United States - epidemiology; Young Adult
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2019.05.020

To assess depression, anxiety, and stress in parents of patients with retinoblastoma and to evaluate the impact of unifocal vs multifocal retinoblastoma. A cross-sectional, self-reported psychological assessment of parents of patients with retinoblastoma at a tertiary care ocular oncology center was performed. The Beck Depression Inventory–II (BDI), Beck Anxiety Inventory (BAI), The Parental Stress Index 4–Short Form, and a retinoblastoma Knowledge Assessment questionnaire were administered. Descriptive statistics for outcomes and comparative analyses were made. There were 138 parents of children with retinoblastoma (unifocal: n = 77, multifocal: n = 61). Overall, parents displayed mild, moderate, or severe depression (BDI) (n = 37, 26.7%); mild, moderate, or severe anxiety (BAI) (n = 49, 35.8%), and stress scores within normal limits (n = 138, 100%). A comparison (unifocal vs multifocal) revealed parents of children with multifocal retinoblastoma with severe depression (1.4% vs 10.2%, P < .02), and no differences in anxiety or stress. Factors associated with moderate or severe parental depression included previous history of depression (30.0% vs 3.9%, P < .001) and factors for moderate or severe anxiety included previous history of depression (33.3% vs 8.6%, P < .001), parent highest level of education at high school or less vs college or beyond (29.2% vs 10.9%, P = .031), and parental report of “child developmental delay” (31.5% vs 11.3%, P = .019). The majority of parents displayed minimal depression (73.3%), anxiety (64.2%), or stress (100%). However, severe depression is more often found in those whose children have multifocal disease, and previous history of depression and less education can impact psychological function. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.