Prevalence of Posttraumatic Stress Disorder in Women With Breast Cancer

Green, Bonnie L.; Rowland, Julia H.; Krupnick, J.L.; Epstein, Steven A.; Stockton, Patricia; Stern, Nicole M.; Spertus, Ilyse L; Steakley, Caryn

doi:10.1016/s0033-3182(98)71356-8

Cited by 231 publications

(187 citation statements)

References 19 publications

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“…These findings differ distinctly from the prevalence of major depression associated with receiving a primary diagnosis of sporadic cancer (14 -38%) [7][8][9] or the prevalence of current PTSD (2.5-6.0%) or lifetime PTSD (4.0 -5.0%) in survivors of breast carcinoma. 10,11 Genetic tests for probands generally are highly specific but quite insensitive, and the negative test results in probands essentially means uninformative results for the family and an inability to pursue any further genetic diagnosis among relatives. Thus, the limitations of genetic test results may contribute to the lower impact of psychologic distress.…”

Section: Discussionmentioning

confidence: 99%

“…4 -6 However, because these reports only assessed psychologic distress using various self-rating questionnaires, it is difficult to compare the rates of clinically significant psychologic distress after a primary diagnosis of sporadic cancer (14 -38%) [7][8][9] or the prevalence of current posttraumatic stress disorder (PTSD) (2.5-6.0%) among breast carcinoma survivors. 10,11 Similarly, although feelings of guilt are a known, specific psychosocial response among individuals undergoing genetic testing, 12,13 previous reports were based on anectodotal experience. 13 Therefore, to our knowledge, no studies to date have investigated the degree or persistence of feelings of guilt in detail after the disclosure of genetic test results.…”

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confidence: 99%

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Psychologic distress after disclosure of genetic test results regarding hereditary nonpolyposis colorectal carcinoma

Murakami

Okamura

Sugano

et al. 2004

Cancer

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BACKGROUNDTo the authors' knowledge, there have been few studies of the psychologic distress after disclosure of genetic test results for hereditary nonpolyposis colorectal carcinoma (HNPCC). The objectives of this study were to identify the prevalence rates and predictors of psychologic distress and to evaluate the feelings of guilt after disclosure of the test results in Japanese probands and unaffected relatives.METHODSProbands and unaffected relatives were interviewed immediately after the first genetic counseling session for HNPCC and again 1 month after disclosure of the genetic test results. The prevalence of major and minor depression, acute stress disorder (ASD), posttraumatic stress disorder (PTSD), and posttraumatic stress symptoms (PTSS) were assessed using the Structured Clinical Interview based on the Diagnostic and Statistical Manual of Mental Disorders, 3rd edition revised (DSM‐III‐R) or the DSM‐IV; feelings of guilt were investigated using a numeric scale and a semistructured interview.RESULTSAmong 47 participants who completed the baseline interview, 42 participants (89%) completed the 1‐month follow‐up interview. Although none of the participants met the criteria for major depression, ASD, or PTSD at the follow‐up interview, 3 of 42 participants (7%) met the criteria for minor depression and 2 participants (5%) had PTSS. The only predictor of psychologic distress found was the presence of a history of major or minor depression (odds ratio, 19.41; 95% confidence interval, 1.42–264.95; P < 0.05). Five of 42 participants (12%) had feelings of guilt.CONCLUSIONSDisclosure of genetic test results for HNPCC may not cause significant psychologic distress in Japanese probands or relatives. However, healthcare providers should not neglect to assess these individuals for psychologic responses, such as minor depression and PTSS. Cancer 2004. © 2004 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Psychologic distress after disclosure of genetic test results regarding hereditary nonpolyposis colorectal carcinoma

Murakami

Okamura

Sugano

et al. 2004

Cancer

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“…Furthermore, Ward et al 21 found that 30% of a sample of 38 breast cancer patients reported that treatment completion was upsetting, and some in our own group have observed that 27% of patients rated the end of radiation and 48% rated the end of chemotherapy as moderately or extremely stressful in a study of 160 women with breast cancer. 22 In a longitudinally designed study, McQuellon et al 23 found that energy levels had recovered to only 70% of normal at 1 year after bone marrow transplantation.…”

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confidence: 99%

Promoting adjustment after treatment for cancer

Stanton

Ganz

Rowland

et al. 2005

Cancer

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The transition from the period of diagnosis and medical treatment of cancer to survivorship (i.e., the reentry phase) is an understudied phase in the cancer trajectory. The objectives of this report were 1) to illustrate several adaptive tasks of the reentry phase, 2) to provide examples of research on factors that predict positive adjustment during this phase, and 3) to discuss interventions that address the adaptive tasks of early cancer survivorship. Although the pertinent empirical literature is scarce, accounts from cancer survivors, healthcare professionals, and qualitative researchers converge to suggest several themes in adaptive tasks during reentry. Drawing from the authors' work and that of others, the authors have described common expectancies held by many individuals approaching reentry (e.g., "I shouldn't need support"), typical concerns during this phase (e.g., concern over cancer recurrence), and personal and contextual factors that can facilitate and

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“…The majority of the available data come not from studies determining patients' syndromal or subsyndromal PTSD diagnoses, but from patient self-reports of traumatic symptoms found to be correlated with poor quality of life and/or impaired physical functioning (e.g., Diemling, Kahana, Bowman, & Schaefer, 2002;Jacobsen et al, 1998; for a review, see Kangas, Henry, & Bryant, 2002 (Gurevich et al, 2002;Kangas et al, 2002), only 8 studies used diagnostic interviews (e.g., SCID; First, Spitzer, Gibbon, & Williams, 1996). Across studies, 0 to 10 patients with PTSD were identified, for a total of 40 PTSD cases in the literature from over 700 patients assessed (Alter et al, 1996;Brewin, Watson, McCarthy, Hyman, & Dayson, 1998;Green et al, 1998;Kangas, Henry, & Bryant, 2005;Mehnert & Koch, 2007;Mundy et al, 2000;Palmer, Kagee, Coyne, & DeMichele, 2004;Pitman et al, 2001). Thus, a study of more cases of PTSD would be useful, but clarifying the clinical picture for those with subsyndromal PTSD would be of particular value.…”

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confidence: 99%

PTSD diagnoses, subsyndromal symptoms, and comorbidities contribute to impairments for breast cancer survivors

Shelby

Golden-Kreutz

Andersen

2008

Journal of Traumatic Stress

118

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The clinical importance of posttraumatic stress disorder (PTSD) symptomatology for cancer patients is unclear. The association between the magnitude of cancer-related PTSD symptoms, comorbidity, and functioning is tested. Breast cancer patients (N = 74) were assessed at diagnosis/surgery, followed, and screened for cancer-related PTSD 18 months later. Participants then completed diagnostic interviews and PTSD (n = 12), subsyndromal PTSD (n = 5), and no symptom (n = 47) patient groups were identified. Posttraumatic stress disorder cases were distinguished by having experienced violent traumas and anxiety disorders predating cancer, whereas subsyndromal cases were not. Also, longitudinal data show that PTSD covarys with poorer functioning and lower quality of life among breast cancer survivors. Both PTSD and subsyndromal PTSD were associated with employment absenteeism and the seeking of mental health services.Studies of posttraumatic stress disorder (PTSD) in cancer patients find that diagnostic rates are low (3% to 14%), but symptomatology falling short of the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; American Psychiatric Association [APA], 1994)-PTSD that is subsyndromal-may occur in upward of 50% of patients (Gurevich, Devins, & Rodin, 2002). How disabling subsyndromal PTSD may be for any individual is not fully known; however, the few data suggest that it is so. Stein, Walker, Hazen, and Forde (1997) using community survey data found that individuals with subsyndromal PTSD reported employment problems, social disruptions, and difficulties in the home. Similarly, Ciechanowski, Walker, Russo, Newman, and Katon (2004) found in a general survey of women in a health maintenance organization that quality of life was lower among those with subsyndromal PTSD compared to those with no symptoms. Finally, Marshall and colleagues (2001), using data from over 9,000 adults screened for anxiety disorders, reported that the presence of subsyndromal symptoms significantly raised the risk for suicidal ideation.It is not known if similar disruptions occur for cancer survivors. The majority of the available data come not from studies determining patients' syndromal or subsyndromal PTSD diagnoses, but from patient self-reports of traumatic symptoms found to be correlated with poor quality of life and/or impaired physical functioning (e.g., Diemling, Kahana, Bowman, & Schaefer, 2002;Jacobsen et al., 1998; for a review, see Kangas, Henry, & Bryant, 2002 (Gurevich et al., 2002;Kangas et al., 2002), only 8 studies used diagnostic interviews (e.g., SCID; First, Spitzer, Gibbon, & Williams, 1996). Across studies, 0 to 10 patients with PTSD were identified, for a total of 40 PTSD cases in the literature from over 700 patients assessed (Alter et al., 1996;Brewin, Watson, McCarthy, Hyman, & Dayson, 1998;Green et al., 1998;Kangas, Henry, & Bryant, 2005;Mehnert & Koch, 2007;Mundy et al., 2000;Palmer, Kagee, Coyne, & DeMichele, 2004;Pitman et al., 2001). Thus, a study ...

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Prevalence of Posttraumatic Stress Disorder in Women With Breast Cancer

Cited by 231 publications

References 19 publications

Psychologic distress after disclosure of genetic test results regarding hereditary nonpolyposis colorectal carcinoma

Psychologic distress after disclosure of genetic test results regarding hereditary nonpolyposis colorectal carcinoma

Promoting adjustment after treatment for cancer

PTSD diagnoses, subsyndromal symptoms, and comorbidities contribute to impairments for breast cancer survivors

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