Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany.
Medical Clinic and Policlinic 1, Hematology and Cellular Therapy, Leipzig University Hospital, Leipzig, Germany.
Acta Oncol. 2023 Sep;62(9):1110-1117. doi: 10.1080/0284186X.2023.2239477. Epub 2023 Jul 30.
Symptoms of posttraumatic stress disorder (PTSD) and adjustment disorder (AjD) are common in hematological cancer patients as they face severe stressors during their serious disease and often intensive treatment, such as stem cell transplantation (SCT). Aims of the present study were to provide frequency and risk factors for PTSD and AjD based on updated diagnostic criteria that are lacking to date.
In a cross-sectional study, hematological cancer patients were assessed for stressor-related symptoms via validated self-report questionnaires based on updated criteria for PTSD (PCL-5) and AjD (ADMN-20). Frequency and symptom severity were estimated among the total sample and SCT subgroups (allogeneic, autologous, no SCT). SCT subgroups were compared using Chi-squared-tests and ANOVAs. Linear regression models investigated sociodemographic and medical factors associated with symptomatology.
In total, 291 patients were included (response rate: 58%). 26 (9.3%), 66 (23.7%) and 40 (14.2%) patients met criteria for cancer-related PTSD, subthreshold PTSD and AjD, respectively. Symptom severity and frequency of criteria-based PTSD and AjD did not differ between SCT subgroups (all > 0.05). Factors associated with elevated symptomatology were younger age (PTSD: < 0.001; AjD: = 0.02), physical comorbidity (PTSD: < 0.001; AjD: < 0.001) and active disease (PTSD: = 0.12; AjD: = 0.03).
Based on new criteria, a considerable part of hematological cancer patients reports PTSD and AjD symptoms. Younger patients and patients with physical symptom burden might be particularly at risk and need to be monitored closely to enable effective treatment at an early stage.
在面对严重疾病和密集治疗（如干细胞移植[SCT]）时，血液病患者会经历创伤后应激障碍（PTSD）和适应障碍（AjD）等症状，这些症状较为常见。本研究旨在根据目前缺乏的最新诊断标准，提供 PTSD 和 AjD 的频率和风险因素。
在一项横断面研究中，通过基于 PTSD（PCL-5）和 AjD（ADMN-20）的更新标准的验证自评问卷，评估血液病患者的应激相关症状。在总样本和 SCT 亚组（异体、自体、无 SCT）中估计频率和症状严重程度。使用卡方检验和方差分析比较 SCT 亚组。线性回归模型调查与症状相关的社会人口统计学和医学因素。
共纳入 291 例患者（应答率：58%）。分别有 26 例（9.3%）、66 例（23.7%）和 40 例（14.2%）患者符合癌症相关 PTSD、阈下 PTSD 和 AjD 的标准。SCT 亚组之间基于标准的 PTSD 和 AjD 的症状严重程度和频率无差异（均>0.05）。与升高的症状学相关的因素是年龄较小（PTSD：<0.001；AjD：=0.02）、躯体共病（PTSD：<0.001；AjD：<0.001）和活动性疾病（PTSD：=0.12；AjD：=0.03）。
根据新标准，相当一部分血液病患者报告了 PTSD 和 AjD 症状。年轻患者和躯体症状负担重的患者可能面临特别的风险，需要密切监测，以便在早期进行有效治疗。
