Course and predictors of post‐traumatic stress disorder in a cohort of psychologically distressed patients with cancer: A 4‐year follow‐up study
Tóm tắt
Scant evidence exists on the long‐term course of cancer‐related post‐traumatic stress disorder (PTSD). This is among the few studies worldwide, and the first in the South‐East Asian region, to prospectively evaluate PTSD in patients with cancer using gold‐standard clinical interviews. The objective of the study was to assess the course and predictors of PTSD in adult patients with cancer in a South‐East Asian population.
A prospective, longitudinal study was conducted in a cohort of 469 consecutively recruited patients (aged ≥18 years) with various cancer types within 1 month of diagnosis at a single oncology referral center. Only patients who had significant psychological distress (Hospital Anxiety and Depression Scale total cutoff score ≥16) underwent the PTSD module of the Structured Clinical Interview for the
In an analysis combining patients who had both full and subsyndromal PTSD, there was a 21.7% incidence of PTSD at the 6‐month follow‐up assessment (n = 44 of 203 SCID‐interviewed patients), with rates dropping to 6.1% at the 4‐year follow‐up assessment (n = 15 of 245 SCID‐interviewed patients). Patients with breast cancer (compared with those who had other types of cancer) were 3.68 times less likely to develop PTSD at 6‐months, but not at 4‐years follow‐up.
The overall rates of PTSD decreased with time, but one‐third of patients (34.1%) who were initially diagnosed had persistent or worsening PTSD 4 years later. There is a need for early identification of this subset of patients who have cancer with PTSD to design risk‐targeted interventions.
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Tài liệu tham khảo
American Psychiatric Association, 1994, Diagnostic and Statistical Manual of Mental Disorders
Crowe C, 2015, A Canadian summary: posttraumatic stress disorder in cancer patients, J Pain Manage., 8, 179
Arnaboldi P, 2014, PTSD symptoms as a consequence of breast cancer diagnosis: clinical implications [serial online], Springerplus., 3, 392, 10.1186/2193-1801-3-392
Mei Hsien CC, 2012, Discrepancy in patient‐rated and oncologist‐rated performance status on depression and anxiety in cancer: a prospective study protocol [serial online], BMJ Open., 2, pii, 10.1136/bmjopen-2012-001799
Yusoff N, 2011, Psychometric properties of the Malay version of the Hospital Anxiety and Depression Scale: a study of husbands of breast cancer patients in Kuala Lumpur, Malaysia, Asian Pac J Cancer Prev., 12, 915
First MB, 1996, Structured Clinical Interview for DSM‐IV Disorders—Research Version (SCID‐I, Version 2.0)
Franklin CL, 2015, Defining subthreshold PTSD in the DSM‐IV literature: a look toward DSM‐5, J Nerv Ment Dis., 203, 574, 10.1097/NMD.0000000000000332
IBM Corporation, 2011, SPSS Statistics for Windows, version 20.0 [software program]
Burri A, 2014, Differences in prevalence rates of PTSD in various European countries explained by war exposure, other trauma and cultural value orientation [serial online], BMC Res Notes., 7, 1, 10.1186/1756-0500-7-407