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Published in:

01-04-2017

Posttraumatic stress disorder symptomatology in the course of allogeneic HSCT: a prospective study

Authors: Peter Esser, Katharina Kuba, Angela Scherwath, Lena Schirmer, Frank Schulz-Kindermann, Andreas Dinkel, Friedrich Balck, Uwe Koch, Nicolaus Kröger, Heide Götze, Anja Mehnert

Published in: Journal of Cancer Survivorship | Issue 2/2017

Abstract

Purpose

Despite the life-threatening character of allogeneic hematopoietic stem cell transplantation (allogeneic HSCT), very few longitudinal research exists on posttraumatic stress disorder (PTSD) symptomatology in this patient group. We investigated prevalence, temporal course and predictors of PTSD symptomatology in this population.

Methods

Patients were assessed before conditioning (T0), 100 days (T1), and 12 months after HSCT (T2). PTSD symptomatology was measured with the PTSD Checklist—Civilian Version. We conducted multilevel modeling and multiple regression analyses.

Results

Two hundred thirty-nine patients participated at baseline, 150 at T1, and 102 at T2. Up to 15 % met the criteria for PTSD at least once during the course of assessment. Fifty-two percent showed diagnostic relevant levels of intrusion, 30 % of avoidance, and 33 % of arousal at least once. Apart from arousal, which increased between T0 and T1 (γ = 0.56, p = 0.03), no other severity score significantly differed between time points. Being impaired by pain (γ = 2.89, p < 0.01), pain level (γ = 0.63, p = 0.02), and being female (γ = 3.81, p < 0.01) emerged as significant predictors of PTSD symptomatology when taking into account all time points. Acute plus chronic graft-versus-host-disease and longer hospital stay predicted PTSD symptomatology at T2 (γ = 3.39, p = 0.04; γ = 0.1, p = 0.03).

Conclusions

A considerable number of patients undergoing allogeneic HSCT met the criteria for PTSD. PTSD symptomatology is prominent at all assessment points. Burden of pain, being female, and medical complications are risk factors for elevated levels of PTSD symptomatology.

Implications for cancer survivors

Psychological support should be offered not only after treatment but also in the long-term and even before HSCT. Professionals should be aware of the psychological consequences accompanied by pain and complications.

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Title: Posttraumatic stress disorder symptomatology in the course of allogeneic HSCT: a prospective study
Authors: Peter Esser
Katharina Kuba
Angela Scherwath
Lena Schirmer
Frank Schulz-Kindermann
Andreas Dinkel
Friedrich Balck
Uwe Koch
Nicolaus Kröger
Heide Götze
Anja Mehnert
Publication date: 01-04-2017
Publisher: Springer US
Published in: Journal of Cancer Survivorship / Issue 2/2017
Print ISSN: 1932-2259
Electronic ISSN: 1932-2267
DOI: https://doi.org/10.1007/s11764-016-0579-7

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Abstract

Purpose

Methods

Results

Conclusions

Implications for cancer survivors

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