Geffen David B, Blaustein Anat, Amir Marianne C, Cohen Yoram
Department of Oncology, Soroka-University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Leuk Lymphoma. 2003 Nov;44(11):1925-9. doi: 10.1080/1042819031000123573.
Post-traumatic stress disorder (PTSD) has not been examined systematically in long-term survivors of lymphoma. In this study, PTSD and health related quality of life (HRQoL) were assessed in 44 patients with Hodgkin's disease (n = 8) or non-Hodgkin's lymphoma (n = 36). Forty-four individuals who had experienced traumatic events as defined by the Diagnostic and Statistical Manual-IV (DSM-IV) as possible triggers for PTSD served as controls. The study participants were administered two questionnaires-the PTSD inventory scale and the Short Form-36 (SF-36) HRQoL instrument measuring physical and mental HRQoL. Full PTSD was defined as meeting the DSM-IV criteria for the diagnosis in all three symptom groups measured on the PTSD inventory scale-intrusion, avoidance and hyper-arousal and partial PTSD as meeting the diagnostic criteria in two of the symptom groups. There was a significant increase in the hyper-arousal scale in the lymphoma survivor group (F 5, P < 0.05). Overall, full or partial PTSD was found in 14 lymphoma survivors (32%) and in 11 individuals (25%) in the control group (difference not significant). Survivors whose disease had started at an earlier age suffered significantly more intensive intrusion and avoidance symptoms. The lymphoma survivor group had a significantly lower physical HRQoL than the control group independent of PTSD symptoms. In both groups, the presence of PTSD symptoms correlated with a lower HRQoL. These results suggest that lymphoma is a trauma similar to other more accepted definitions of trauma which can lead to PTSD, and is associated with more severe hyper-arousal symptoms. Psychological interventions in the early stages of treatment or follow-up may help reduce the morbidity from PTSD and improve quality of life.
创伤后应激障碍（PTSD）尚未在淋巴瘤长期幸存者中得到系统研究。在本研究中，对44例霍奇金病患者（n = 8）或非霍奇金淋巴瘤患者（n = 36）的PTSD和健康相关生活质量（HRQoL）进行了评估。44名经历过《精神疾病诊断与统计手册》第四版（DSM-IV）定义的可能引发PTSD的创伤性事件的个体作为对照。研究参与者接受了两份问卷——PTSD量表和测量生理及心理HRQoL的简短健康调查（SF-36）工具。完全PTSD定义为在PTSD量表测量的所有三个症状组（侵入、回避和过度警觉）中均符合DSM-IV诊断标准，部分PTSD定义为在两个症状组中符合诊断标准。淋巴瘤幸存者组的过度警觉量表得分显著增加（F = 5，P < 0.05）。总体而言，14名淋巴瘤幸存者（32%）和11名对照组个体（25%）被发现患有完全或部分PTSD（差异不显著）。疾病发病年龄较早的幸存者遭受的侵入和回避症状更严重。无论PTSD症状如何，淋巴瘤幸存者组的生理HRQoL显著低于对照组。在两组中，PTSD症状的存在都与较低的HRQoL相关。这些结果表明，淋巴瘤是一种与其他更被认可的创伤定义类似的创伤，可导致PTSD，并与更严重的过度警觉症状相关。在治疗或随访的早期阶段进行心理干预可能有助于降低PTSD的发病率并改善生活质量。
