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To the Editor: In their study describing adverse health outcomes in long-term survivors of childhood cancer, Dr Geenen and colleagues¹ do not adequately discuss the effect of psychological trauma in these patients. Children who are exposed to chronic illnesses (especially those that are life-threatening) may experience sleep disturbances and nightmares, thought suppression, difficulties in concentration, memory problems, loss of motivation, intense fear, irritability, and aggression toward their parents and peers.^2-3

Furthermore, such children may develop acute stress disorder, learning disorders, regressive behaviors, somatization, dissociative disorders, separation problems, and posttraumatic stress disorder and depression.^2-5 Older children and adolescents may experience a loss of faith in the future because they realize that life is fragile.³ They may become involved in high-risk sexual behaviors as well as abuse of alcohol, illicit drugs, and tobacco, which may compromise their health status considerably, given the severity of their medical condition.^{2, 4}

Persons involved with the care . . . [Full Text of this Article]

Marina Kakaki, MD
mkakaki@in.gr
Social Security Institution
Child Mental Health Center
Athens, Greece

Christos Theleritis, MD
Psychiatry Department
Eginition Hospital
Athens

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