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The Effects of Attention Problems on Psychosocial Functioning in Childhood Brain Tumor Survivors

A 2-Year Postcraniospinal Irradiation Follow-up

Oh, Yunhye MD; Seo, Hyunjung MD; Sung, Ki Woong MD, PhD; Joung, Yoo Sook MD, PhD

Journal of Pediatric Hematology/Oncology: March 2017 - Volume 39 - Issue 2 - p e46–e53
doi: 10.1097/MPH.0000000000000766
Online Articles: Original Articles

Objective: To examine the psychosocial outcomes and impact of attention problems in survivors of pediatric brain tumor.

Study Design: The survivors’ cognitive functioning was measured using the Wechsler Intelligence Scale for Children. The Child Behavior Checklist-Attention Problems scale was used to screen for attention problems, and participants were classified as having attention problems (n=15) or normal attention (n=36). Psychosocial functioning was examined with the Korean Personality Rating scale for Children (K-PRC) at precraniospinal radiation and at 2-year follow-up.

Results: The attention problem group showed significantly higher depression and externalizing symptoms (delinquency, hyperactivity) and more significant impairment in family relationships than did the normal attention group at baseline. At follow-up, the attention problem group demonstrated significantly more delinquency and impaired family and social relationships. With the K-PRC scores, except for the somatization, social relationship subscale, there were significant differences between groups, but not in terms of treatment by time interaction or within time. At follow-up, multiple linear regressions showed that age at diagnosis significantly predicted K-PRC somatization (B=−1.7, P=0.004) and social relationships (B=−1.7, P=0.004), baseline full-scale intelligence quotient predicted K-PRC depression (B=−0.4, P=0.032) and somatization (B=−0.3, P=0.015), and attention problems at baseline predicted K-PRC depression (B=−15.2, P=0.036) and social relationships (B=−11.6, P=0.016).

Conclusion: Pediatric brain tumor survivors, in particular, patients with attention problems, had worse psychosocial functioning at baseline and follow-up. Attention problems at baseline need to be carefully evaluated in assessing psychosocial functioning of pediatric brain tumor survivors.

Departments of *Psychiatry

Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

The authors declare no conflict of interest.

Reprints: Yoo Sook Joung, MD, PhD, Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Korea (e-mail:

Received January 9, 2016

Accepted December 5, 2016

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.