Anxiety, depression and distress in pediatric oncology: Patterns from a single-center cohort

Children undergoing cancer treatment are at heightened risk for psychological difficulties, yet emotional symptom patterns during hospitalization remain incompletely characterized. This single-center observational cohort study examined anxiety, depressive symptoms, and psychological distress among hospitalized pediatric oncology patients at a tertiary care hospital. Anxiety was assessed using the Children’s Anxiety scale, depressive symptoms were measured using the Depression Inventory and Patient Health Questionnaire, and global psychological distress was evaluated using the Distress Thermometer. Non-parametric statistical methods were applied to examine diagnosis-related differences and associations between anxiety and depressive symptoms. A total of 20 pediatric oncology patients were included. Overall, patients demonstrated elevated levels of anxiety, depressive symptoms, and psychological distress during hospitalization. Significant diagnosis-related differences were observed, with patients diagnosed with acute lymphoblastic leukemia exhibiting higher anxiety, depressive symptoms, and distress compared with patients diagnosed with acute myeloid leukemia and other malignancies. Anxiety and depressive symptoms showed a very strong positive association, indicating substantial co-occurrence and shared variance between these emotional domains. These findings indicate that emotional distress in pediatric oncology inpatients is both prevalent and highly interconnected, with diagnosis serving as a clinically meaningful context for psychological vulnerability. The results underscore the importance of integrated, diagnosis-informed psycho-oncological assessment and support the routine incorporation of comprehensive psychological screening into pediatric oncology care to facilitate early identification of high-risk emotional profiles and timely psychosocial intervention.