PTSD Incidence in Cancer Patients Remains High at 4-Years Follow-Up

Post-traumatic stress disorder (PTSD) may be persistent or worsening in patients with cancer up to 4 years after an initial diagnosis of the disorder, according to the results of a study of South-East Asian patients published recently in Cancer.

“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.”

According to the researchers, there were no prior studies looking at the incidence of PTSD in patients with cancer that have used clinical interviews and followed patients for long periods of time. In this prospective study, they assessed both the course and predictors of PTSD in 469 consecutively recruited patients with various cancer types within 1 month of diagnosis.

Those patients with significant psychological distress underwent 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 then completed the interview again 4 years later.

By combining both patients with full (13.3%) and subsyndromal (8.4%) PTSD, the 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 wrote that this high rate of PTSD was “striking” and that the fact that “Asian patients with cancer are disproportionally affected by PTSD compared with Caucasians may explain the higher rate of PTSD” reported in this study.

Of the patients initially diagnosed with full PTSD at 6-month follow-up, 22.2% had full PTSD at the 4-year follow-up; of the remaining patients, 11.1% had no PTSD, 7.4% had subsyndromal PTSD, and the rest were lost to follow-up or had died.

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.”