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Although participants’ rates of PTSD declined with time, the data underscore the risk of developing persistent PTSD even years after cancer diagnosis and treatment, according to the authors of the study. About one-third of patients (34.1%) initially diagnosed with PTSD or some of its symptoms went on to develop chronic or worsening PTSD four years later.
“There is a need for early identification of this subset of patients who have cancer with PTSD to design risk-targeted interventions,” concluded Caryn Mei Hsien Chan, Ph.D., of the National University of Malaysia in Kuala Lumpur and colleagues.
Moreover, finding ways to monitor PTSD among patients living with cancer is critical because many of its symptoms, such as avoidance and cognitive difficulties, are enduring, which may potentially impact adherence to treatment, the authors noted.
The study involved face-to-face interviews with 469 patients within one month of cancer diagnosis. Participants took the Hospital Anxiety and Depression Scale (HADS) at the outset and four weeks to six weeks later. Those who were found to have psychological distress underwent the PTSD module of the Structured Clinical Interview for DSM-IV (SCID) at six months. At the four-year follow-up, the SCID was used to assess PTSD in all 245 living patients, regardless of their HADS scores.
The high rate of PTSD found in the study may be partly due to the higher risk of PTSD found in Asian patients with cancer, compared with patients of Caucasian descent, the researchers wrote. The researchers also included so-called “subsyndromal” PTSD cases: patients whose symptoms lasted less than one month or who did not meet the threshold for a DSM-IV diagnosis despite the presence of multiple symptoms.
The study also found that patients with breast cancer were 3.68 times less likely to have PTSD at the six-month follow-up than those with other types of cancer, but not at the four-year follow-up. “Because breast cancer is a very common malignancy, it is possible that greater societal understanding and the wider availability of support programs tailored for breast cancer (compared with fewer support programs for patients with other cancer types) initially serve as protective factors against PTSD,” the authors wrote.
For related information, see the Psychiatric News article “Mental Health Issues in Cancer Survivors Persist Long After Treatment Ends.”
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