Cancer, an international interdisciplinary journal of the American Cancer Society, recently published a study of South-East Asian patients that demonstrates that post-traumatic stress disorder (PTSD) may become persistent or even worsen in cancer patients up to four years after their diagnosis.
“Our data underscore the risk of developing persistent PTSD even years after cancer diagnosis and treatment,” wrote Caryn Mei Hsien Chan, PhD, of the National University of Malaysia, and colleagues. “Approximately one-third (34.1%) of patients with cancer who are initially diagnosed with full or subsyndromal PTSD at 6 months went on to develop chronic or full PTSD at 4-years follow-up.”
No previous studies had evaluated the incidence of PTSD in patients with cancer using clinical interviews and tracking patients’ health for long periods of time. This study evaluated both the course and predictors of PTSD in 469 consecutively recruited patients with various types of cancer who were recruited within one month of diagnosis.
Patients demonstrating significant psychological distress were given the PTSD module of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision at 6 months follow-up. All patients completed the same interview four years later.
By combining both patients with full (13.3%) and subsyndromal (8.4%) PTSD, researchers found about a one in five (21.7%) incidence of PTSD at the 6-month follow-up. The rate of PTSD decreased to 6.1% at the 4-year follow-up.
The researchers considered this high rate of PTSD “striking.” They also stated that the fact that “Asian patients with cancer are disproportionally affected by PTSD compared with Caucasians, [and this] may explain the higher rate of PTSD” reported in this study.
Of the patients initially diagnosed with full PTSD at 6-month follow-up
- 2% had full PTSD at the 4-year follow-up
- 1% had no PTSD
- 4% had subsyndromal PTSD
- the rest did not follow up or had passed away.
Overall, about one-third (34.1%) of cancer patients initially diagnosed with full or subsyndromal PTSD at 6 months went on to develop full PTSD at 4 years.
“The high rates of PTSD in our study indicate that Asian patients with cancer may be at higher risk of developing PTSD within the first 6 months of diagnosis and treatment rather than later on during the survivorship period,” the researchers wrote. “Our results underline the importance of specifically screening for PTSD in cancer survivors with high levels of psychological distress, because one-third of these patients met the criteria for PTSD at the 4-year follow-up assessment.”
According to Dr. Linda Gantt, owner and executive director of Help for Trauma, “Invasive medical procedures are an often unrecognized cause of PTSD and are often overlooked when taking a medical or psychological history.”