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Journal of Cancer Survivorship
Published in: Journal of Cancer Survivorship 5/2016

01-10-2016

Aspects of posttraumatic stress disorder in long-term testicular cancer survivors: cross-sectional and longitudinal findings

Authors: Alv A. Dahl, Marie Østby-Deglum, Jan Oldenburg, Roy Bremnes, Olav Dahl, Olbjørn Klepp, Erik Wist, Sophie D. Fosså

Published in: Journal of Cancer Survivorship | Issue 5/2016

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Abstract

Purpose

The purpose of this research is to study the prevalence of posttraumatic stress disorder (PTSD) and variables associated with PTSD in Norwegian long-term testicular cancer survivors (TCSs) both cross-sectionally and longitudinally.

Methods

At a mean of 11 years after diagnosis, 1418 TCSs responded to a mailed questionnaire, and at a mean of 19 years after diagnosis, 1046 of them responded again to a modified questionnaire. Posttraumatic symptoms related to testicular cancer were self-rated with the Impact of Event Scale (IES) at the 11-year study only. An IES total score ≥35 defined Full PTSD, and a score 26–34 identified Partial PTSD, and the combination of Full and Partial PTSD defined Probable PTSD.

Results

At the 11-year study, 4.5 % had Full PTSD, 6.4 % had Partial PTSD, and 10.9 % Probable had PTSD. At both studies, socio-demographic variables, somatic health, anxiety/depression, chronic fatigue, and neurotoxic adverse effects were significantly associated with Probable PTSD in bivariate analyses. Probable anxiety disorder, poor self-rated health, and neurotoxicity remained significant with Probable PTSD in multivariate analyses at the 11-year study. In bivariate analyses, probable PTSD at that time significantly predicted socio-demographic variables, somatic health, anxiety/depression, chronic fatigue, and neurotoxicity among participants of the 19-year study, but only probable anxiety disorder remained significant in multivariable analysis.

Conclusions

In spite of excellent prognosis, 10.9 % of long-term testicular cancer survivors had Probable PTSD at a mean of 11 years after diagnosis. Probable PTSD was significantly associated with a broad range of problems both at that time and was predictive of considerable problems at a mean of 19 year postdiagnosis.

Implications for cancer survivors

Among long-term testicular cancer survivors, 10.9 % have Probable PTSD with many associated problems, and therefore health personnel should explore stress symptoms at follow-up since efficient treatments are available.
Literature
1.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: American Psychiatric Press; 1994.
2.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: American Psychiatric Press; 2013.
3.
Mehnert A, Vehling S, Scheffold K, Ladehoff N, Schön G, Wegscheider K, et al. Prävalenz von Anpassungsstörungen, akuter und Posttraumatischer Belastungsstörungen sowie Somatoformen Störungen bei Krebspatienten. Psychother Psychosom Med. 2013;63:466–72.CrossRef
4.
O’Connor M, Christensen S, Jensen AB, Møller S, Zachariae R. How traumatic is breast cancer? Post-traumatic stress symptoms (PTSS) and risk factors for severe PTSS at 3 and 15 months after surgery in a nationwide cohort of Danish women treated for primary breast cancer. Br J Cancer. 2011;104:419–26.CrossRefPubMedPubMedCentral
5.
Tjemsland J, Søreide JA, Malt UF. Posttraumatic distress symptoms in operable breast cancer III: status one year after surgery. Breast Cancer Res Treat. 1998;47:141–51.CrossRefPubMed
6.
Rustad JK, David D, Currier MB. Cancer and post-traumatic stress disorder: diagnosis, pathogenesis and treatment considerations. Palliat Support Care. 2012;10:213–23.CrossRefPubMed
7.
Breslau N, Lucia VC, Davis GC. Partial PTSD versus full PTSD: an empirical examination of associated impairment. Psychol Med. 2004;34:1205–14.CrossRefPubMed
8.
Cukor J, Wyka K, Jayasinghe N, Difede JA. The nature and course of subthreshold PTSD. J Anxiety Disord. 2010;24:918–23.CrossRefPubMed
9.
McLaughlin KA, Koenen KC, Friedman MJ, Ruscio AM, Karam EG, Shahly V, et al. Subthreshold posttraumatic stress disorder in the World Health Organization World Mental Health Surveys. Biol Psychiatry. 2015;77:375–84.CrossRefPubMed
10.
Smith SK, Zimmerman S, Williams CS, Preisser JS, Clipp EC. Post-traumatic stress outcomes in Non-Hodgkin’s lymphoma survivors. J Clin Oncol. 2008;26:934–41.CrossRefPubMedPubMedCentral
11.
Smith SK, Zimmerman S, Williams CS, Habtamu B, Abernethy AP, Mayer DK, et al. Post-traumatic stress symptoms in long-term Non-Hodgkin’s lymphoma survivors: does time heal? J Clin Oncol. 2011;29:4526–33.CrossRefPubMedPubMedCentral
12.
Fleer J, Sleijfer D, Hoekstra H, Tuinman M, Klip E, Hoekstra-Weebers J. Objective and subjective predictors of cancer-related stress symptoms in testicular cancer survivors. Patient Educ Couns. 2006;64:142–50.CrossRefPubMed
13.
Wittchen H-U, Gloster A, Beesdo K, Schönefeld S, Perkonigg A. Posttraumatic stress disorder: diagnostic and epidemiological perspectives. CNS Spectr. 2009;14(Suppl 1):5–12.PubMed
14.
Sledjeski EM, Speisman B, Dierker LC. Does number of lifetime traumas explain the relationship between PTSD and chronic medical conditions? Answers from the National Comorbidity Survey-Replication (NCS-R). J Behav Med. 2008;31:341–9.CrossRefPubMedPubMedCentral
15.
Pietrzak RH, Goldstein RB, Southwick SM, Grant BF. Medical comorbidity of full and partial posttraumatic stress disorder in US adults: results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Psychosom Med. 2011;73:697–707.CrossRefPubMedPubMedCentral
16.
Brydøy M, Fosså SD, Klepp O, Bremnes RM, Wist EA, Wentzel-Larsen T, et al. Paternity following treatment for testicular cancer. J Natl Cancer Inst. 2005;97:1580–8.CrossRefPubMed
17.
Thorsen L, Nystad W, Dahl O, Klepp O, Bremnes RM, Wist E, et al. The level of physical activity in long-term survivors of testicular cancer. Eur J Cancer. 2003;39:1216–21.CrossRefPubMed
18.
Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res. 2002;52:69–77.CrossRefPubMed
19.
Chalder T, Berelowitz G, Pawlikowska T, Watts L, Wessely S, Wright D, et al. Development of a fatigue scale. J Psychosom Res. 1993;37:147–53.CrossRefPubMed
20.
Loge JH, Ekeberg O, Kaasa S. Fatigue in the general Norwegian population: normative data and associations. J Psychosom Res. 1998;45:53–65.CrossRefPubMed
21.
Oldenburg J, Fosså SD, Dahl AA. Scale for Chemotherapy-induced Long-term Neurotoxicity (SCIN): psychometrics, validation, and findings in a large sample of testicular cancer survivors. Qual Life Res. 2006;15:791–800.CrossRefPubMed
22.
Eid J, Thayer JF, Johnsen BH. Measuring post-traumatic stress: a psychometric evaluation of symptom- and coping questionnaires based on a Norwegian sample. Scand J Psychol. 1999;40:101–8.CrossRefPubMed
23.
van der Ploeg E, Mooren TTM, Kleber RJ, van der Velden PG, Brom D. Construct validation of the Dutch version of the Impact of Event Scale. Psychol Assess. 2004;16:16–26.CrossRefPubMed
24.
Tuinman MA, Hoekstra HJ, Sleijfer DT, Fleer J, Vidrine DJ, Gritz ER, et al. Testicular cancer a longitudinal pilot study on stress response symptoms and quality of life in couples before and after chemotherapy. Support Care Cancer. 2007;15:279–86.CrossRefPubMed
25.
Wohlfarth TD, van den Brink W, Winkel FW, ter Smitten M. Screening for posttraumatic stress disorder: an evaluation of two self report scales among crime victims. Psychol Assess. 2003;15:101–9.CrossRefPubMed
26.
Neal LA, Busuttil W, Rollins J, Herepath R. Convergent validity of measures of post- traumatic stress disorder in a mixed military and civilian population. J Trauma Stress. 1994;7:447–55.CrossRefPubMed
27.
Aasland OG, Amundsen A, Bovim G, Fauske S, Mørland J. Identification of patients at risk of alcohol related damage (in Norwegian). Tidsskr Nor Laegeforen. 1990;110:1523–7.PubMed
28.
Brugha T, Bebbington P, Tennant C, Hurry J. The List of Threatening Experiences: a subset of 12 life event categories with considerable long-term contextual threat. Psychol Med. 1985;15:189–94.CrossRefPubMed
29.
Ingebrigtsen G, Sandanger I, Sorensen T, Dalgard OS. Posttraumatisk stress forstyrrelser i Norge, forekomst og relasjon til sosialt nettverk. In: Dalgard OS, Døhlie E, Ystgaard M, editors. Sosialt nettverk, helse og samfunn. Oslo: Universitetsforlaget; 1995. p. 64–85. in Norwegian.
30.
Greimel E, Dorfer M, Lambauer M, Bjelic-Radisic V, Gramm S, Lahousen M, et al. Posttraumatic stress disorder in female cancer patients: an inappropriate diagnosis in oncology? Psychother Psychosom. 2013;82:271–2.CrossRefPubMed
31.
Einsle F, Kraft D, Köllner V. Post-traumatic stress disorder (PTSD) in cardiology and oncology—which diagnostic tools should be used? J Psychosom Med. 2012;72:434–8.CrossRef
32.
Gurevich M, Devins GM, Rodin GM. Stress response syndromes and cancer: conceptual and assessment issues. Psychosomatics. 2002;43:259–81.CrossRefPubMed
33.
Kessler RC, Rose S, Koenen KC, Karam EG, Stang PE, Stein DJ, et al. How well can post-traumatic stress disorder be predicted from pre-trauma risk factors? An exploratory study in the WHO World Mental Health Surveys. World Psychiatry. 2014;13:265–74.CrossRefPubMedPubMedCentral
34.
Husky MM, Lépine J-P, Gasquet I, Kovess-Masfety V. Exposure to Traumatic Events and Posttraumatic Stress Disorder in France: Results From the WMH Survey. J Trauma Stress. 2015;28:275–82.
Metadata
Title
Aspects of posttraumatic stress disorder in long-term testicular cancer survivors: cross-sectional and longitudinal findings
Authors
Alv A. Dahl
Marie Østby-Deglum
Jan Oldenburg
Roy Bremnes
Olav Dahl
Olbjørn Klepp
Erik Wist
Sophie D. Fosså
Publication date
01-10-2016
Publisher
Springer US
Published in
Journal of Cancer Survivorship / Issue 5/2016
Print ISSN: 1932-2259
Electronic ISSN: 1932-2267
DOI
https://doi.org/10.1007/s11764-016-0529-4

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