Depression and Complicated Grief Among Parents of Pediatric Cancer Patients in Cameroon: Implications for Global Health in Low-income Countries.

Abstract

Background and objectives: Bereaved parents of pediatric cancer patients frequently experience severe grief and psychological distress, but studies on the prevalence of major depressive disorder (MDD) and complicated grief (CG) among this population in Cameroon are lacking. This study aimed to determine the prevalence of MDD and CG among bereaved parents of deceased pediatric cancer patients treated at Mbingo Baptist Hospital Cameroon, and to identify predictors of these mental health outcomes.

Methods: This cross-sectional study included parents of deceased pediatric cancer patients treated at Mbingo Baptist Hospital between January 2015 and January 2022. Multivariate logistic regression identified predictors of MDD and CG as adjusted odds ratios (AOR) with 95% confidence intervals (CIs).

Results: The prevalence of CG in this population was 86%, while 66.7% of the study subjects screened positive for MDD. Significant predictors of MDD included age [OR 1.091, p=0.018], financial hardship [OR 9.47, p=0.014], accurate knowledge of the child's prognosis [OR 0.268, p=0.046], perceived social support [(poor social support OR 6.402, P=0.039), (moderate social support OR 8.556, p=0.045)], and coping capacity [medium resilient copers OR 7.874, p=0.027]. Predictors of CG included age [OR 1.157, p=0.032], financial hardship [OR 11.501, p=0.04], years passed since child loss [1-2 years OR 4.634, p=0.049], and coping capacity [(low resilient copers OR 14.011, p<0.01), (medium resilient copers OR 19.023, p<0.01)].

Conclusions: The study revealed high prevalence of MDD and CG among bereaved parents of pediatric cancer patients in Cameroon. Financial difficulty, social support, and coping capacity had substantial impact on parental mental health outcomes in this population. Personalized mental health support services into pediatric oncology care is critical for assisting bereaved families and encouraging resilience in the face of loss may improve health and wellbeing of the families. The study may have implications for global mental health in similar low-income countries.