ObjectiveSystematic reviews highlight a broad range of cancer-related post-traumatic stress disorder (CR-PTSD) prevalence estimates in cancer survivors. This meta-analysis was conducted to provide a prevalence estimate of significant CR-PTSD symptoms and full diagnoses to facilitate the psychological aftercare of cancer survivors.MethodsA systematic literature search was conducted for studies using samples of cancer survivors by using validated clinical interviews and questionnaires to assess the prevalence of CR-PTSD (k = 25, n = 4189). Prevalence estimates were calculated for each assessment method using random-effects meta-analysis. Mixed-effects meta-regression and categorical analyses were used to investigate study-level moderator effects.ResultsStudies using the PTSD Checklist—Civilian Version yielded lower event rates using cut-off [7.3%, 95% confidence intervals (CI) = 4.5–11.7, k = 10] than symptom cluster (11.2%, 95% CI = 8.7–14.4, k = 9). Studies using the Structured Clinical Interview for Diagnostic and Statistical Manual, Fourth Edition (SCID), yielded low rates for lifetime (15.3%, 95% CI = 9.1–25, k = 5) and current CR-PTSD (5.1%, 95% CI = 2.8–8.9, k = 9). Between-study heterogeneity was substantial (I2 = 54–87%). Studies with advanced-stage samples yielded significantly higher rates with PTSD Checklist—Civilian Version cluster scoring (p = 0.05), and when assessing current CR-PTSD on the SCID (p = 0.05). The effect of mean age on current PTSD prevalence met significance on the SCID (p = 0.05). SCID lifetime prevalence rates decreased with time post-treatment (R2 = 0.56, p < 0.05).DiscussionThe cancer experience is sufficiently traumatic to induce PTSD in a minority of cancer survivors. Post-hoc analyses suggest that those who are younger, are diagnosed with more advanced disease and recently completed treatment may be at greater risk of PTSD. More research is needed to investigate vulnerability factors for PTSD in cancer survivors.© 2014 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.
Objective: Systematic reviews highlight a broad range of cancer-related post-traumatic stress disorder (CR-PTSD) prevalence estimates in cancer survivors. This meta-analysis was conducted to provide a prevalence estimate of significant CR-PTSD symptoms and full diagnoses to facilitate the psychological aftercare of cancer survivors. Methods: A systematic literature search was conducted for studies using samples of cancer survivors by using validated clinical interviews and questionnaires to assess the prevalence of CR-PTSD (k = 25, n = 4189). Prevalence estimates were calculated for each assessment method using random-effects meta-analysis. Mixed-effects meta-regression and categorical analyses were used to investigate study-level moderator effects. Results: Studies using the PTSD Checklist-Civilian Version yielded lower event rates using cutoff [7.3%, 95% confidence intervals (CI) = 4.5-11.7, k = 10] than symptom cluster (11.2%, 95% CI = 8.7-14.4, k = 9). Studies using the Structured Clinical Interview for Diagnostic and Statistical Manual, Fourth Edition (SCID), yielded low rates for lifetime (15.3%, 95% CI = 9.1-25, k = 5) and current CR-PTSD (5.1%, 95% CI = 2.8-8.9, k = 9). Between-study heterogeneity was substantial (I 2 = 54-87%). Studies with advanced-stage samples yielded significantly higher rates with PTSD Checklist-Civilian Version cluster scoring (p = 0.05), and when assessing current CR-PTSD on the SCID (p = 0.05). The effect of mean age on current PTSD prevalence met significance on the SCID (p = 0.05). SCID lifetime prevalence rates decreased with time post-treatment (R 2 = 0.56, p < 0.05). Discussion: The cancer experience is sufficiently traumatic to induce PTSD in a minority of cancer survivors. Post-hoc analyses suggest that those who are younger, are diagnosed with more advanced disease and recently completed treatment may be at greater risk of PTSD. More research is needed to investigate vulnerability factors for PTSD in cancer survivors.
A study involving 10 female anorectics who satisfied DSM‐III‐R (American Psychiatric Association, 1987) criteria in a new phase of outpatient treatment and 10 healthy female controls matched for age, education, social class, premorbid IQ and geographical habitation, were administered a battery of well‐known neuropsychological tests and rating scales. Personal details concerning subjects' weight history and parents' occupations were also recorded. Significant evidence was found to suggest a difference between the anorectics and the controls on a number of tests and scales. In particular, anorectics performed worse on the third trial of the Auditory Verbal Learning Test and on the Rey‐Osterreith Complex Figure Test (Delayed Recall Trial) possibly implying impairment of the right hemisphere considered to be responsible, in part, for visuospatial ability. This was believed to be one of the reasons for distortion of body image in anorexia nervosa. Strong evidence was also found in support of the coexistence of obsessionality and depression in anorexia nervosa. Since there is growing evidence implicating the caudate nucleus for the obsessionality in obsessive‐compulsive disorder, it was proposed that this association might also be likely to explain the obsessionality in anorexia nervosa, thus supporting hypotheses that propose an organic origin for the condition.
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