Symptoms of posttraumatic stress disorder and adjustment disorder in hematological cancer patients with different treatment regimes

Springer, Franziska; Kuba, Katharina; Ernst, Jochen; Friedrich, Michael; Glaesmer, Heide; Platzbecker, Uwe; Vučinić, Vladan; Heyne, Svenja; Mehnert, Anja; Esser, Peter

doi:10.1080/0284186x.2023.2239477

Cited by 5 publications

(5 citation statements)

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“…However, this research question was investigated via self-report questionnaires and reported in another publication. 26 There was no discernible impact of SCT on PTSD and AjD symptomatology. Furthermore, our detailed assessment of cancer-related stressors may have inflated the amount of events reported.…”

Section: Study Strengths and Limitationsmentioning

confidence: 97%

“…symptomatology 26. However, further studies relating to other cancer entities are needed.Diagnosis of AjD in the context of cancer remained hard to apply.…”

mentioning

confidence: 99%

“…Flow chart. This flow-diagram has been published in a similar form elsewhere26 ; Abbreviations: SCT, stem cell transplantation; † referred by physicians at the study center or practices and self-initiated contact of interested patients; ‡ all patients between 18 and 70 years who were scheduled for the outpatient clinic at the days of recruitment; § no medical information in the records, for example, stem cell donors or patients from other institutions seeking second medical opinion; ¶ already recruited by physicians within first recruitment period (left arm). Sample characteristics of hematological cancer survivors.…”

mentioning

confidence: 99%

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New progress in an old debate? Applying the DSM‐5 criteria to assess traumatic events and stressor‐related disorders in cancer survivors

Springer,

Friedrich,

Kuba

et al. 2023

Psycho-Oncology

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ObjectiveThe rather broad definition of medical trauma within DSM‐IV has contributed to long‐lasting debates on the applicability of Posttraumatic Stress Disorder (PTSD) in oncological patients and its differentiation from Adjustment Disorder (AjD) which results from non‐traumatic critical life events. The DSM‐5 criteria have introduced a narrower definition of medical traumatization. However, studies on updated prevalence rates in cancer patients are missing.MethodsWithin a cross‐sectional study, we assessed hematological cancer survivors using the Structured Clinical Interview for DSM‐5. We investigated (i) the frequency and type of cancer‐related stressors, (ii) the proportion of stressors qualifying as traumatic according to DSM‐5 (i.e., an event of sudden and catastrophic character) and (iii) the prevalence of PTSD, AjD and cancer‐related PTSD according to DSM‐5.Results291 patients participated (response rate: 58%). Mean age was 54 years, 60% were male. 168 patients (59%) reported cancer‐related stressors, with the most frequent being cancer diagnosis disclosure (n = 58, 27%). Eight percent of reported stressors qualified as traumatic events according to DSM‐5. Five (1.8%), 15 (5.3%) and 20 (7.0%) cancer survivors met DSM‐5 criteria for current PTSD, lifetime PTSD and AjD, respectively. Among all PTSD cases, three were cancer‐related (1.1%). In addition, seven patients (2.5%) met all symptoms for cancer‐related PTSD, but not the DSM‐5 criterion for medical trauma. Considering receiving the cancer diagnosis as traumatic event, which is debatable according to DSM‐5, 38% of stressors qualified as traumatic and six patients (2.1%) met criteria for cancer‐related PTSD.ConclusionsDSM‐5 criteria enable a clear identification of traumatic events in the context of cancer. This change may inform discussions on the appropriateness of PTSD in cancer patients and facilitates its differentiation from AjD. Larger studies need to validate our findings.

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Section: Study Strengths and Limitationsmentioning

confidence: 97%

“…symptomatology 26. However, further studies relating to other cancer entities are needed.Diagnosis of AjD in the context of cancer remained hard to apply.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

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New progress in an old debate? Applying the DSM‐5 criteria to assess traumatic events and stressor‐related disorders in cancer survivors

Springer,

Friedrich,

Kuba

et al. 2023

Psycho-Oncology

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“…Most commonly reported factors comprise more invasive treatments, physical comorbidities, younger age, advanced types of cancer and lack of social support (Smith et al, 2008;Cordova et al, 2017;Jung et al, 2021). We recently demonstrated with the same sample of hematological cancer patients that one in three patients suffers from clinically relevant levels of cancer-related PTSD or subthreshold PTSD, and more than half met at least one core symptom cluster of AjD (Springer et al, 2023). Symptoms related to PTSD or AjD, such as avoidance of cancer-related stressors, might influence patients' health behavior, e.g., compliance with self-administered medication.…”

Section: Introductionmentioning

confidence: 95%

“…In total, 291 hematological cancer patients were included in the study [response rate 58%; for more details on the participant flow, see previous publication (Springer et al, 2023)]. In total, 174 (60%) were male and the average age was 55 years (Table 1).…”

Section: Sample Characteristicsmentioning

confidence: 99%

Compliance with medical regimen among hematological cancer patients and its association with symptoms of posttraumatic stress disorder and adjustment disorder

Springer,

Esser,

Friedrich

et al. 2023

Front. Psychol.

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BackgroundHematological cancer patients must comply with extensive medical instructions to prevent cancer progression or relapse. Psychological comorbidities and patient characteristics have been shown to affect compliance. However, the impact of posttraumatic stress disorder (PTSD) and adjustment disorder (AjD) on compliance in cancer patients remains unclear. This study aims to evaluate compliance in hematological cancer patients more comprehensively and to investigate its association with PTSD and AjD symptomatology as well as sociodemographic and medical factors.MethodsHematological cancer patients were cross-sectionally assessed via validated questionnaires for PTSD (PCL-5) and AjD (ADMN-20), and three internally developed items on compliance with medical regimen, with two referring to compliance behavior and one item assessing perceived difficulties with complying. Each compliance item was analyzed descriptively. Multiple linear regression models tested the association between compliance and PTSD and AjD symptomatology, sociodemographic and medical factors.ResultsIn total, 291 patients were included (response rate 58%). Nine out of ten patients reported to either never (67%) or rarely (25%) change their medical regimen. However, 8% reported to change it once in a while or often. Compliance behavior was mostly rated as very easy (36%) or easy (45%) to implement. Nevertheless, 19% perceived it to be partly difficult or difficult to follow medical regimen. Symptoms of AjD (β = 0.31, p < 0.001) were associated with more difficulties to comply. Higher compliance behavior in turn was associated with stem cell transplantation (SCT) treatment (β = −0.21, p < 0.001) and lower education (β = −0.19, p = 0.002).ConclusionAlthough most patients indicated that they comply with medical regimen, a considerable subgroup of patients indicated subjectively perceived difficulties and thus seem to require additional support in implementing medical instructions possibly through improved medical communication and patient health literacy or shared decision-making.

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Psychoonkologie – psychosoziale Belastungen und Versorgungsbedarfe

Mehnert-Theuerkauf,

Springer

2024

Urologie

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Symptoms of posttraumatic stress disorder and adjustment disorder in hematological cancer patients with different treatment regimes

Cited by 5 publications

References 45 publications

New progress in an old debate? Applying the DSM‐5 criteria to assess traumatic events and stressor‐related disorders in cancer survivors

New progress in an old debate? Applying the DSM‐5 criteria to assess traumatic events and stressor‐related disorders in cancer survivors

Compliance with medical regimen among hematological cancer patients and its association with symptoms of posttraumatic stress disorder and adjustment disorder

Psychoonkologie – psychosoziale Belastungen und Versorgungsbedarfe

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