Cancer and Mental Disorder Among Emerging Adults

Abstract

Background: Cancer is the leading disease-cause of mortality among emerging adults aged 15-29 years. In addition to the normative stresses of navigating this critical developmental period, the trauma of living with cancer can have long-term psychiatric consequences for emerging adults. However, there is a lack of information on the adverse psychiatric effects of cancer during emerging adulthood and how mental health outcomes compare to other developmental periods in adulthood. Objectives: Given the scarce information about how cancer impacts mental health outcomes of emerging adults, this study provided overall and sex-specific prevalence estimates of mental disorders for emerging adults with cancer, compared the risk of mental disorders stratified by sex status, and examined the experiences of mental healthcare utilization needs across emerging adults with cancer. Methods: The Canadian Community Health Survey—Mental Health (CCHS-MH) was used for this study. The CCHS-MH collected information on mental health outcomes, healthcare utilization, perception of healthcare support and general health statuses among Canadians aged ≥15 years. The World Health Organization Composite International Diagnostic Interview (WHO-CIDI) 3.0 was used as a diagnostic measure of mental disorders according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) criteria. Mental service use was assessed by asking participants whether they had consulted a number of different health professionals for their mental health. Results: The prevalence of mental disorders for emerging adults with cancer was 42.9% for any mental disorders, 22.9% for substance use disorders (SUD), and 12.5% for mood disorders. Male emerging adults with cancer had lower odds of reporting any mental disorders [OR = 0.62; CI = (0.16 – 2.35)] compared to female emerging adults with cancer [OR = 1.37; CI = (0.43 – 4.27)]. Female emerging adults with cancer reported higher odds of SUDs and mood disorders compared to their counterparts without cancer. Emerging adults with cancer were shown to be positively associated with a higher risk of reporting unmet perceived needs for care [OR = 7.72; CI = (1.85 – 28.57)]. Conclusion: Emerging adults with cancer require specific mental healthcare services tailored to their unique developmental period. Future interdisciplinary involvement with key stakeholders including healthcare professionals from both the psychiatric and oncology setting will be key for developing numerous intervention techniques to address emerging adults through all stages of their cancer diagnosis. It will be important to invest research into exploring what kind of mental health services is the most effective in reducing the burden of mental disorders for emerging adults with cancer.