PhDs in Focus: Understanding the risk of developing mental health conditions among children and young people after a cancer diagnosis
Welcome to our PhDs in Focus blog series, where our PhD students are showcasing their pioneering research projects at the National Institute for Health and Care Research (NIHR) Manchester Biomedical Research Centre (BRC).
In this blog, Manchester BRC PhD student Moe Zandy outlines how their PhD project is investigating the risk of developing mental health conditions among children and young people who have been diagnosed with cancer, as part of the Living With and Beyond Cancer theme.
Having worked as an epidemiologist in British Columbia, Canada, I developed a keen interest in mental health research, particularly during the COVID-19 pandemic when disruptions to daily life highlighted the importance of mental health. Epidemiologists are public health researchers who investigate patterns and causes of disease. At the British Columbia Centre for Disease Control (BCCDC), I led public health surveillance efforts assessing the pandemic’s impact on Canadians, and I have since published my findings in a peer-reviewed journal.
My PhD project
Driven by my growing passion for mental health research, I pursued a PhD in epidemiology. This goal came to fruition through a grant provided by the National Institute for Health and Care Research (NIHR) Manchester Biomedical Research Centre (BRC) which funds my PhD research project. The project contributes to the Living with and Beyond Cancer (LWBC) BRC theme, and its objectives and outcomes also link to the Mental Health theme.
Using anonymised electronic health records from general practices (GPs) and hospitals that form the Clinical Practice Research Datalink (CPRD), my PhD research project aims to describe the epidemiology of mental health conditions in England and the related risk of developing psychiatric conditions (e.g., depression), neurodevelopmental conditions (e.g., autism spectrum disorder), non-fatal self-harm, and death by suicide among children and young people (CYP) after a cancer diagnosis. The CPRD is a research service that collects anonymised patient data from GP practices in the UK, making it possible to conduct longitudinal public health and clinical studies.
Cancer and mental health
CYP diagnosed with cancer face many challenges, affecting not just their physical health but also their mental wellbeing. While not all CYP with cancer will develop mental health problems, some do. In a study of patients at 3+ years post cancer diagnosis, the reported incidence (new occurrence) of any psychiatric disorders among adolescents and young adults with cancer was 61% . Studies also show that CYP with cancer are more likely to experience problems like anxiety, depression, attention deficit hyperactivity disorder (ADHD), or be on the autism spectrum (1,2). However, the factors contributing to these mental health issues, such as gender, ethnicity, socioeconomic status, and cancer type, are not fully understood, and need further investigation.
It’s important to understand the kinds of mental health issues CYP with cancer might have to optimise healthcare delivery. A better understanding of mental health conditions and related risks among CYP after a cancer diagnosis will create an opportunity to provide streamlined and tailored care while potentially reducing healthcare costs.
My research
I plan to examine patients’ electronic health records to quantify the incidence of mental health conditions among CYP diagnosed with cancer and determine if they are more likely to have mental health conditions compared to their siblings and other CYP without cancer. I also aim to identify factors that might increase the likelihood of these mental health problems, observe how they change over time, and assess whether the COVID-19 pandemic has exacerbated the need for mental health-related healthcare services.
References
- Lee ARYB, Low CE, Yau CE, Li J, Ho R, Ho CSH. Lifetime Burden of Psychological Symptoms, Disorders, and Suicide Due to Cancer in Childhood, Adolescent, and Young Adult Years: A Systematic Review and Meta-analysis. JAMA Pediatr. 2023 Aug 1;177(8):790–9.
- Hsu TW, Liang CS, Tsai SJ, Bai YM, Su TP, Chen TJ, et al. Risk of Major Psychiatric Disorders Among Children and Adolescents Surviving Malignancies: A Nationwide Longitudinal Study. J Clin Oncol Off J Am Soc Clin Oncol. 2023 Apr 10;41(11):2054–66.