Journal Article

Behavioral and emotional problems and quality of life in Chinese children with Langerhans cell histiocytosis

Ma, Honghao, Li, Ying, Li, Shijie, Liang, Aimin, Du, Juan, Zhang, Rui, Lian, Hongyun

2026

Overview

Objective This study intended to explore behavioral and emotional problems and quality of life, as well as their related factors in Chinese children with Langerhans cell histiocytosis (LCH). Methods This was a cross-sectional study. Subjects were included from April 2023 to September 2023. Child behavior checklist (CBCL), pediatric quality of life inventory™ version 4.0 (PedsQL TM 4.0), and version 3.0 (PedsQL TM 3.0) Cancer Module were used to assess behavioral and emotional problems and quality of life. Results A total of 120 children with LCH were included. Twenty-six (21.7%) children had behavioral and emotional problems. Age at diagnosis ≥ 4 years [odds ratio (OR) = 0.344, P  = 0.022] and major caregiver with an educational level of junior college and above (OR = 0.314, P  = 0.035) were independently associated with a lower possibility of achieving CBCL total problem score ≥ 35. Electronic product usage time ≥ 2 h per day ( B =-6.024, P  = 0.011) and caesarean section ( B =-6.006, P  = 0.012) were independently related to a lower total PedsQL TM 4.0 score, while age at diagnosis ≥ 4 years ( B  = 9.183, P  = 0.004) showed an inverse trend. Second-line treatment was independently related to a lower total PedsQL TM 3.0 Cancer Module score ( B =-5.578, P  = 0.021). Conclusion In this study, 21.7% of Chinese children with LCH exhibit behavioral and emotional problems. Age at diagnosis < 4 years, major caregiver with an educational level of high school and below, electronic product usage time ≥ 2 h, caesarean section, and second-line treatment are related to behavioral and emotional problems and impaired quality of life in Chinese children with LCH. Clinical trial number Not applicable.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adolescent / Affective disorders / Affective Symptoms - epidemiology / Affective Symptoms - etiology / Anxiety / Autoimmune diseases / Behavior / Behavioral and emotional problems / Cancer / Caregivers / Cesarean section / Child / Child Behavior Disorders - epidemiology / Child Behavior Disorders - etiology / Child, Preschool / Children / China - epidemiology / Community colleges / Complications and side effects / Cross-Sectional Studies / East Asian People / Emotional regulation / Female / Histiocytosis / Histiocytosis, Langerhans-Cell - complications / Histiocytosis, Langerhans-Cell - psychology / Humans / Infant / Internal Medicine / Langerhans cell histiocytosis / Male / Medicine / Medicine & Public Health / Mental disorders / Pediatric research / Pediatrics / Prevalence / Problem Behavior / Quality of Life / Questionnaires / Regression analysis / Risk factors / Variance analysis