The Course of Psychological Disorders in the 1st Year After Cancer Diagnosis.

Abstract

This study investigated the relationship between acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) and comorbid anxiety, depressive, and substance use disorders over the first 12-month period following a cancer diagnosis. Individuals recently diagnosed with 1st onset head and neck or lung malignancy were assessed for ASD within the initial month following their diagnosis and reassessed for PTSD and other psychological disorders at both 6 months and 12 months following their cancer diagnosis. The incidence for PTSD at 12 months (14%) was lower than the incidence for other anxiety (20%) and depressive (20%) disorders. This study points to the need for the development of valid therapeutic interventions to assist this population in the 1st year following their diagnosis.

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

“…Other difficulties for patients with PTSD were also identified. Rates of prior mood (75%) and substance use disorders (33%) were high, a pattern similar to that found among head and neck and lung cancer patients with PTSD (Kangas et al, 2005;Kugaya et al, 2000). Both classes of disorders can be a sequelae of posttraumatic stress (Ozer et al, 2003).…”

“…To date, four cancer studies have reported comorbidity rates for PTSD cases. Green and colleagues (1998) reported 11%, Mundy et al (2000) reported 28%, and Kangas et al (2005) reported up to 71% of their PTSD cases had concurrent depression. Mehnert and Koch (2007) reported that women diagnosed with cancer-related PTSD or acute stress disorder were more likely (Odds Ratio [OR] = 22.2) to have a comorbid disorder.…”

“…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.…”

Depression in cancer: The many biobehavioral pathways driving tumor progression

“…For instance, in an epidemiological survey exploring the prevalence of depressive symptoms among subjects of five biennial waves of the Health and Retirement Study, involving 8,387 individuals aged 51-61, subjects diagnosed with cancer had the highest hazard ratio of depressive symptoms within 2 years following initial diagnosis (HR 3.55; 95%, CI, 2.79-4.52), when compared to individuals diagnosed with diabetes, hypertension, heart disease, arthritis, chronic lung disease or stroke 20 . The chances of developing a new depressive episode following a diagnosis of cancer may be elevated in certain vulnerable groups (e.g., those patients with a previous history of depressive episodes), as suggested by an observational study exploring the relationship between acute stress disorder and subsequent depressive symptoms after a diagnosis of head/neck/lung cancer 21 . In this study up to 29% of individuals met the criteria for MDD within the first month after the diagnosis, of whom nearly one-third had a positive history for previous depressive episodes 21 .…”

“…The chances of developing a new depressive episode following a diagnosis of cancer may be elevated in certain vulnerable groups (e.g., those patients with a previous history of depressive episodes), as suggested by an observational study exploring the relationship between acute stress disorder and subsequent depressive symptoms after a diagnosis of head/neck/lung cancer 21 . In this study up to 29% of individuals met the criteria for MDD within the first month after the diagnosis, of whom nearly one-third had a positive history for previous depressive episodes 21 .…”