Medical Student Research Fellowship for Summer 2011

Mentor:                        Patrick Leavey
Department:                  Pediatrics
Room number:  G3240
Mail Code:                   9063
Phone number:  214-648-3074
E-mail:                          Patrick.leavey@utsouthwestern.edu
Project title:                  Identification of Anxiety and Depression in Children with Cancer

Human subjects IRB approved project number (where applicable):102008-011           
Animal subjects IRB approved project number (where applicable):        N/A

Project Type: Patient based

Brief Description of Project:

Investigators at the CCBD have been running a clinical observational trial to establish the prevalence of depression and anxiety in children with cancer. The study has been open for 2 years and enrolled approximately 70 patients. Multiple time points involving multiple surveys for depression, anxiety, quality of life and hope have been completed by both parents and their children (our patients).

Susan Wu will explore this data set and perform subset analysis to observe how depression and perceived quality of life correlate with a variety of clinically relevant factors, including but not limited to reported level of pain, type of cancer, time since diagnosis, surgery, and treatment intensity as well as patient demographics such as age, gender and ethnicity. She is interested in exploring how socioeconomic status (SES), as proxied by income by zip code according to the US census, or insurance coverage might impact anxiety or depression. Coping will be looked at in the context of recent family stressors, as indicated by the parent for the previous 3 months, to see how situations at home may influence the mental well-being of patients. We will explore the variation in recent stressors by patient age, ethnicity, and SES. We will also examine the data at a micro-level to see how answers to specific questions on the CDI, PHQ-9, and STAI correlate to patient characteristics such as SES or recent stressors.

Two different survey instruments have been used to evaluate anxiety and depression in patients. The PHQ-9 is significantly shorter than the CDI and has been used predominantly in adult populations. Susan will evaluate differences in depression as reported by the two instruments. She will also compare evaluations of depression as completed by patients and their parents, to see if parental evaluation accurately reflects patient condition.

Susan will have the opportunity to participate in patient enrollment and data collection with our study coordinator and child psychologist throughout the summer. She will learn the appropriate methods of statistical analysis for data of this nature and be responsible for evaluating the statistical relationships she has chosen to address.

Previous Research Activities or Publications with Medical Students:

Abstracts:

1. Skip Metastasis (SM) in Osteosarcoma: a 25 Year Institutional Review. Day, M.D., Booth, T.,  Maale, G., and Leavey, P.J. J Pediatr Hematol Oncol Vol 23, (3), pA19, #1190.  The American Society of Pediatric Hematology / Oncology 14th Annual Meeting, Baltimore, Maryland in April 2001

1. The use of antidepressant medications (AD) in children with cancer. Tobey,D., McLaughlin,A., Scott,S., Bash,R., Ahmad,N., Portteus, A., Slone,T. and Leavey,P.J. Pediatr Blood Cancer 2005, Vol 44,(6), p561, #1154. Presented at the 18th Annual meeting of the American Society of Pediatric Hematology / Oncology and 2005 Annual Pediatric Academic Societies Meeting, Washington D.C., May 2005.
2. Radiation induced lung injury in survivors of childhood cancer.  Stegner M, Luckett P, Fitzgerald J, Eshelman D, Cochran C, and Leavey P.  Abstract presented at the 10th International Conference on Long-Term Complications of Treatment of Children and Adolescents for Cancer, June 6-7, 2008, Niagra-on-the-Lake, Ontario, Canada.
3. Radiation Induced Pulmonary Injury in Survivors Following Whole Lung Irradiation for a Childhood Malignancy. Stegner M, Luckett P, Fitzgerald J, Eshelman D, Cochran C, and Leavey P. Presented at the Annual meeting of the American Society of Pediatric Hematology/Oncology, 2009.

Manuscripts:

1. Day M, Edwards AO, Weinberg A, Leavey PJ. Brief report: successful therapy of a patient with infantile generalized myofibromatosis. Med Pediatr Oncol 2002; 38:371-373.

1. Leavey PJ, Day MD, Booth T, Maale G. Skip metastasis in osteosarcoma. J Pediatr Hematol Oncol 2003; 25:806-808.

1. Portteus A, Ahmad N, Tobey D and Leavey P. The Prevalence and Use of Anti-depressant Medication (ADM) in Pediatric Cancer Patients. J Child Adolesc Psychopharmacol 2006; 16(4):467-473.