PTSD symptom clusters associated with short- and long-term adjustment in early diagnosed breast cancer patients

Abstract

Objectives We performed an observational prospective cohort study to investigate post-traumatic stress symptoms, emerging after cancer diagnosis, which could influence patients’ short- and long-term adjustment to illness, in order to foster screening measures and management of psychological factors in daily clinical pathways. Methods Patients’ post-traumatic stress symptoms, psychological well-being and perceived quality of life were assessed through standardised questionnaires. The Profile of Mood States questionnaire was administered at pre-operative assessment (T0), surgical admission (T1) and discharge from hospital (T2). The Impact of Event Scale and the State-Trait Anxiety Inventory were administered at T0, T1, T2 and 2 years after discharge (T3). At 2-year follow-up, women were also asked to rate their perceived quality of life on a 0–10 visual analogue scale. Results Between January 2014 and April 2015, 150 women were enrolled. Results showed that more than 90% of patients experienced post-traumatic stress symptoms after cancer diagnosis (14% with severe symptoms and 76.7% with moderate symptoms) and post-traumatic stress disorder (PTSD) symptoms that persisted up to the 2-year from discharge follow-up, with significant improvement only 2 years after hospital discharge. In particular, mediation models showed that intrusive thoughts impede mood adjustment to the disease during the pre-surgical phase, with anxiety amplifying the negative effect, while symptoms of avoidance are more detrimental in the long term for patients’ quality of life. Conclusion PTSD symptom clusters have different influence on short- and long-term reaction to illness. Based on this evidence, appropriate interventions to manage PTSDs in the context of oncology should be developed.

“You do not get cancer by chance”: Communicating the role of environmental causes in cancer diseases and the risk of a “guilt rhetoric”

“…Both cancer diagnosis and long-term adjustment to the disease are associated with notable emotional experience, which may reach a psychopathological status (eg, post-traumatic stress disorder [PTSD]). 5 Furthermore, cancer patients have to deal with difficult decisions in terms of treatment options, which may be for most painful, long-lasting, and full of side effects and thus detrimental to one's individual and social well-being. 6 Even after successful treatment, oncological patients experience continual fear of recurrence and the need to completely reform their everyday life and future plans.…”

“…However, any communication on cancer and oncology is expected to reach not only those people who still have the opportunity to prevent it but even those who are currently fighting the disease, patients or survivors. Both cancer diagnosis and long‐term adjustment to the disease are associated with notable emotional experience, which may reach a psychopathological status (eg, post‐traumatic stress disorder [PTSD]) . Furthermore, cancer patients have to deal with difficult decisions in terms of treatment options, which may be for most painful, long‐lasting, and full of side effects and thus detrimental to one's individual and social well‐being .…”

Patients Living With Breast Cancer During the Coronavirus Pandemic: The Role of Family Resilience, Coping Flexibility, and Locus of Control on Affective Responses

“…Oncology patients, for example, have already experienced a severe adverse traumatic event – cancer diagnosis and prognosis – which can introduce important emotional consequences ( Williams, 2002 ) and coping challenges ( Nipp et al, 2016 ). Coping flexibility ( Oliveri et al, 2019a ) is therefore considered a valuable tool that allows such patients to reduce distress ( Bonanno et al, 2011 ) during stressful circumstances ( Roussi et al, 2007 ) like the COVID-19 pandemic. Coping flexibility remains especially vital in reconciling the need to both elaborate the trauma and maintain a positive outlook toward the future after the event has subsided ( Bonanno et al, 2008 ).…”

One-Year Quality of Life Trends in Early-Stage Lung Cancer Patients After Lobectomy

“…It would be also important to collect data on the effects of other psychological aspects that may significantly impact the trend of patients' QoL. For example, illness perception, resilience, coping, and self-efficacy are only some of the important aspects that should be measured over the care cycle and may modify patients' recovery after surgery (Greco et al, 2015 ; Hu et al, 2018 ; Oliveri et al, 2019 ). Interpersonal variables, such as patient–physician communication and trust, are other factors that may affect patients' care process (Kenny et al, 2010 ; Petrocchi et al, 2019 ).…”