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Cancer and post-traumatic stress disorder: Diagnosis, pathogenesis and treatment considerations

Published online by Cambridge University Press:  22 March 2012

James K. Rustad ,
Daniella David  and
M. Beatriz Currier
James K. Rustad
Affiliation:
Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida
Daniella David
Affiliation:
Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida
M. Beatriz Currier*
Affiliation:
Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida
*
Address correspondence and reprint requests to: M. Beatriz Currier, Courtelis Center for Psychosocial Oncology, Department of Psychiatry and Behavioral Sciences, University of Miami/Miller School of Medicine, Sylvester Comprehensive Cancer Center, 1475 N.W. 12th Avenue, Suite C023A, Miami, FL 33136. E-mail: bcurrier@med.miami.edu
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Abstract

Objective:

The purpose of this article was to review the literature regarding diagnosis, pathogenesis, and treatment of post-traumatic stress disorder (PTSD) associated with cancer.

Method:

We surveyed studies examining the validity of diagnostic scales commonly used to measure PTSD in patients with cancer. Neurobiological underpinnings of PTSD and cancer, including inflammation as the physiological mechanism linking these comorbidities, were examined. Psychopharmacologic and psychotherapeutic treatment of PTSD symptoms in patients with cancer was reviewed. In addition, potential drug–drug interactions between psychotropic medications commonly used to treat PTSD and anti-cancer agents were reviewed.

Results:

Multiple studies demonstrated the validity of the PTSD Checklist Civilian Version (PCL-C) in diagnosing PTSD in patients with cancer. Research has shown that PTSD as defined in DSM-IV appears to be a better model for conceptualizing distress in patients with cancer than a generalized “distress” model. Epidemiologic studies have shown an increased incidence of PTSD associated with cancer; however, literature regarding characteristics of PTSD in patients with cancer is cross-sectional in nature.

Significance of results:

Future research focusing on longitudinal, prospective studies to identify patients at risk, determine causal or aggravating factors, and develop preventive interventions is needed. Further study of PTSD in patients with cancer may help increase recognition of this disorder, optimize treatment, and enhance the quality of life of these individuals.

Keywords

CancerPTSDEpidemiologyPathophysiologyDrug interactions
Type
Review Articles
Information
Palliative & Supportive Care , Volume 10 , Issue 3 , September 2012 , pp. 213 - 223
Copyright
Copyright © Cambridge University Press 2012

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References

REFERENCES

Ahmadi, N., Hajsadeghi, F., Mirshkarlo, H.B., et al. (2010). Post-traumatic stress disorder, coronary atherosclerosis, and mortality. The American Journal of Cardiology, 108, 29–33.CrossRefGoogle Scholar
Alter, C.L., Pelcovitz, D., Axelrod, A., et al. (1996). Identification of PTSD in Cancer Survivors. Psychosomatics, 37, 137–143.CrossRefGoogle ScholarPubMed
American Psychiatric Association. (1980). Diagnostic and Statistical Manual of Mental Disorders, 3rd ed.Washington, DC: American Psychiatric Association Publishing.Google Scholar
American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th ed.Washington, DC: American Psychiatric Association Publishing.Google Scholar
American Psychiatric Association Work Group on ASD and PTSD. (2004). Practice guidelines for the treatment of patients with acute stress disorder and posttraumatic stress disorder. Washington, DC: American Psychiatric Association Publishing.Google Scholar
Andrykowski, M.A. (1994). Psychiatric and psychosocial aspects of bone marrow transplantation. Psychosomatics, 35, 13–24.CrossRefGoogle ScholarPubMed
Antoni, M.H., Wimberly, S.R., Lechner, S.C., et al. (2006). Reduction of cancer-specific thought intrusions and anxiety symptoms with a stress management intervention among women undergoing treatment for breast cancer. American Journal of Psychiatry, 163, 1791–1797.CrossRefGoogle ScholarPubMed
Asmundson, G.J.G., Frombach, I., McQuaid, J., et al. (2000). Dimensionality of posttraumatic stress symptoms: A confirmatory factor analysis of DSM-IV symptom clusters and other symptom models. Behaviour Research and Therapy, 38, 203–214.CrossRefGoogle ScholarPubMed
Baker, F., Zabora, J., Polland, A., et al. (1999). Reintegration after bone marrow transplantation. Cancer Practice, 7, 190–197.CrossRefGoogle ScholarPubMed
Beijnen, J.H. & Schellens, J.H.M. (2004). Drug interactions in oncology. The Lancet Oncology, 5, 489–496.CrossRefGoogle ScholarPubMed
Bisson, J.I., Ehlers, A., Matthews, R., et al. (2007). Psychological treatments for chronic post-traumatic stress disorder: Systematic review and meta-analysis. British Journal of Psychiatry, 190, 97–104.CrossRefGoogle ScholarPubMed
Breitbart, W. & Heller, K.S. (2003). Reframing hope: Meaning-centered care for patients near the end of life. Journal of Palliative Medicine, 6, 979–988.CrossRefGoogle ScholarPubMed
Breitbart, W., Rosenfield, B., Gibson, C., et al. (2010). Meaning-centered group psychotherapy for patients with advanced cancer: a pilot randomized controlled trial. Psycho-oncology, 19, 21–28.CrossRefGoogle Scholar
Buckley, T.C. & Kaloupek, D.J. (2001). A meta-analytic examination of basal cardiovascular functioning in PTSD. Psychosomatic Medicine, 63, 585–594.CrossRefGoogle Scholar
Buckley, T.C., Mozley, S.L., Bedard, M.A., et al. (2004). Preventive health behaviors, health-risk behaviors, physical morbidity, and health-related role functioning impairment in veterans with post-traumatic stress disorder. Military Medicine, 169, 536–540.CrossRefGoogle ScholarPubMed
Capuron, L., Pagnoni, G., Demetrashvilli, M., et al. (2005). Anterior cingulate activation and error processing during interferon-alpha treatment. Biological Psychiatry, 58, 190–196.CrossRefGoogle ScholarPubMed
Classen, C., Butler, L.D., Koopman, C., et al. (2001). Supportive-expressive group therapy and distress in patients with metastatic breast cancer: A randomized clinical intervention trial. Archives of General Psychiatry, 58, 494–501.CrossRefGoogle ScholarPubMed
Cordova, M.J. & Andrykowski, M.A. (2003). Responses to cancer diagnosis and treatment: posttraumatic stress and posttraumatic growth. Seminars in Clinical Neuropsychiatry, 8, 286–296.Google ScholarPubMed
Cordova, M.J., Studts, J.L., Hann, D.M., et al. (2000). Symptom structure of PTSD following breast cancer. Journal of Traumatic Stress, 13, 301–319.CrossRefGoogle ScholarPubMed
Davidson, J.R.T., Brady, K., Mellman, T.A., et al. (2007). The efficacy and tolerability of tiagabine in adult patients with post-traumatic stress disorder. Journal of Clinical Psychopharmacology, 27, 85–88.CrossRefGoogle ScholarPubMed
Davidson, J.R.T., Connor, K.M. & Zhang, W. (2009). Treatment of anxiety disorders. In: Textbook of Psychopharmacology, 4th ed.Schatzberg, A.F. & Nemeroff, C.B. (eds.), pp. 1171–1199. Washington, D.C.: American Psychiatric Publishing.Google Scholar
Davis, L., Davidson, J.R.T., Ward, L.C., et al. (2008). Divalproex in the treatment of posttraumatic stress disorder: A randomized, double-blind, placebo-controlled trial in a veteran population. Journal of Clinical Psychopharmacology, 28, 84–88.CrossRefGoogle Scholar
Derogatis, L. (1975). Brief Symptom Inventory. Baltimore: Clinical Psychometric Research.Google Scholar
Dinarello, C.A. (2006). The paradox of pro-inflammatory cytokines in cancer. Cancer and Metastasis Reviews, 25, 307–313.CrossRefGoogle ScholarPubMed
DuHamel, K.N., Ashman, T., Keane, T.M., et al. (2004). Construct validity of the posttraumatic stress disorder checklist in cancer survivors: Analysis based on two samples. Psychological Assessment, 16, 255–266.CrossRefGoogle ScholarPubMed
First, M.B., Spitzer, R.L., Gibbon, M., et al. (2002). Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition (SCID-I/P). New York: Biometrics Research, New York State Psychiatric Institute.Google Scholar
Floyd, F.J. & Widaman, K.F. (1995). Factor analysis in the development and refinement of clinical assessment instruments. Psychological Assessment, 7, 286–299.CrossRefGoogle Scholar
Foa, E.B., Keane, M.J., Friedman, M.J., et al. (2008). Effective Treatments for PTSD: Practice guidelines from the International Society for Traumatic Stress Studies, 2nd ed.New York: Guilford Press.Google Scholar
Frankl, V.E. (1992). Man's Search for Meaning: An Introduction to Logotherapy, 4th ed.Boston: Beacon Press.Google Scholar
Green, B.L., Rowland, J.H., Krupnick, J.L., et al. (1998). Prevalence of posttraumatic stress disorder (PTSD) in women with breast cancer. Psychosomatics, 32, 102.Google Scholar
Greenstein, M. & Breitbart, W. (2000). Cancer and the experience of meaning: A group psychotherapy program for people with cancer. American Journal of Psychotherapy, 54, 486–500.CrossRefGoogle ScholarPubMed
Gurevich, M., Devins, G.M. & Rodin, G.M. (2002). Stress response syndromes and cancer: conceptual and assessment issues. Psychosomatics, 43, 259–281.CrossRefGoogle ScholarPubMed
Hamner, M.B., Faldowski, R.A., Robert, S., et al. (2009). A preliminary controlled trial of divalproex in posttraumatic stress disorder. Annals of Clinical Psychiatry, 21, 89–94.Google ScholarPubMed
Heim, C. & Nemeroff, C.B. (2009). Neurobiology of posttraumatic stress disorder. CNS Spectrums, 14, 13–24.Google ScholarPubMed
Horowitz, M., Wilner, N. & Alvarez, W. (1979). Impact of Event Scale: A measure of subjective stress. Psychosomatic Medicine, 41, 209–218.CrossRefGoogle Scholar
Jim, H.S.L. & Jacobsen, P.B. (2008). Posttraumatic stress and posttraumatic growth in cancer survivorship: A review. The Cancer Journal, 14, 414–419.CrossRefGoogle ScholarPubMed
Kangas, M., Henry, J.L. & Bryant, R.A. (2002). Posttraumatic stress disorder following cancer: A conceptual and empirical review. Clinical Psychology Review, 22, 499–524.CrossRefGoogle Scholar
Kessler, R.C., Berglund, P., Demler, O., et al. (2005a). Lifetime prevalence and age-of onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 593–602.CrossRefGoogle ScholarPubMed
Kessler, R.C., Chiu, W.T., Demler, O., et al. (2005b). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the national comorbidity survey replication. Archives of General Psychiatry, 62, 617–627.CrossRefGoogle ScholarPubMed
Kiecolt-Glaser, J.K., Loving, T.J., et al. (2005). Hostile marital interactions, proinflammatory cytokine production, and wound healing. Archives of General Psychiatry, 62, 266–272.CrossRefGoogle ScholarPubMed
Lethborg, C.E., Kissane, D., Burns, W.I., et al. (2000). “Cast adrift”: The experience of completing treatment among women with early stage breast cancer. Journal of Psychosocial Oncology, 18, 73–90.CrossRefGoogle Scholar
Ma, A.M.T., Barone, J., Wallis, A.E., et al. (2008). Noncompliance with adjuvant radiation, chemotherapy, or hormonal therapy in breast cancer patients. The American Journal of Surgery, 196, 500–504.CrossRefGoogle ScholarPubMed
Maes, M., Song, C., Lin, A., et al. (1998). The effects of psychological stress on humans: Increased production of pro-inflammatory cytokines and a Th-1 like response in stress-induced anxiety. Cytokine, 10, 313–318.CrossRefGoogle Scholar
Maes, M., Lin, A., Delmeire, L., et al. (1999). Elevated serum interleukin-6 (IL-6) and IL-6 receptor concentrations in post-traumatic stress disorder following accidental man-made traumatic events. Biological Psychiatry, 45, 833–839.CrossRefGoogle ScholarPubMed
Mason, J.W., Wang, S., Yehuda, R., et al. (2002). Marked lability in urinary cortisol levels in subgroups of combat veterans with posttraumatic stress disorder during an intensive exposure treatment program. Psychosomatic Medicine, 64, 238–246.CrossRefGoogle ScholarPubMed
McDade, T.W., Hawkley, L.C. & Cacioppo, J.T. (2006). Psychosocial and behavioral predictors of inflammation in middle-aged and older adults: The Chicago health, aging and social relations study. Psychosomatic Medicine, 68, 376–381.CrossRefGoogle Scholar
McNally, R.J. (2003). Progress and controversy in the study of posttraumatic stress disorder. Annual Review of Psychology, 54, 229–252.CrossRefGoogle Scholar
Miller, A.H. (2009). Norman Cousins Lecture: Mechanisms of cytokine–induced behavioral changes: Psychoneuroimmunology at the translational interface. Brain, Behavior, and Immunity, 23, 149–158.CrossRefGoogle Scholar
Miller, A.H., Ancoli-Israel, S., Bower, J.E., et al. (2008). Neuroendocrine-immune mechanisms of behavioral comorbidities in patients with cancer. Journal of Clinical Oncology, 26, 971–982.CrossRefGoogle ScholarPubMed
Miller, A.H., Maletic, V. & Raison, C.L. (2009). Inflammation and its discontents: The role of cytokines in the pathophysiology of major depression. Biological Psychiatry, 65, 732–741.CrossRefGoogle ScholarPubMed
Mundy, E. & Baum, A. (2004). Medical disorders as a cause of psychological trauma and posttraumatic stress disorder. Current Opinion in Psychiatry, 17, 123–128.CrossRefGoogle Scholar
Musselman, D.L., Lawson, D.H., Gumnick, J.F., et al. (2001). Paroxetine for the prevention of depression induced by high-dose interferon alpha. New England Journal of Medicine, 344, 961–966.CrossRefGoogle Scholar
Paulus, M.P., Feinstein, J.S., Simmons, A., et al. (2004). Anterior cingulate activation in high trait anxious subjects is related to altered error processing during decision making. Biological Psychiatry, 55, 1179–1187.CrossRefGoogle ScholarPubMed
Schnurr, P.P. & Spiro, A. (1999). Combat exposure, posttraumatic stress disorder symptoms, and health behaviors as predictors of self-reported physical health in older veterans. The Journal of Nervous and Mental Disease, 187, 353–359.CrossRefGoogle ScholarPubMed
Shelby, R.A., Golden-Kreutz, D.M. & Andersen, B.L. (2005). Mismatch of posttraumatic stress disorder (ptsd) symptoms and DSM-IV symptom clusters in a cancer sample: Exploratory factor analysis of the ptsd checklist-civilian version. Journal of Traumatic Stress, 18, 347–357.CrossRefGoogle Scholar
Smith, M.Y., Redd, W., DuHamel, K., et al. (1999). Validation of the PTSD checklist-civilian version in survivors of bone marrow transplantation. Journal of Traumatic Stress, 12, 485–499.CrossRefGoogle ScholarPubMed
Stearns, V., Johnson, M.D., Rae, J.M., et al. (2003). Active tamoxifen metabolite plasma concentrations after coadministration of tamoxifen and the selective serotonin reuptake inhibitor paroxetine. Journal of the National Cancer Institute, 95, 1758–1764.CrossRefGoogle ScholarPubMed
Stein, M.B., Walker, J.R., Haze, A.L., et al. (1997). Full and partial posttraumatic stress disorder: findings from a community survey. American Journal of Psychiatry, 154, 1114–1119.Google ScholarPubMed
Taylor, S., Kuch, K., Koch, W.J., et al. (1998). The structure of posttraumatic stress symptoms. Journal of Abnormal Psychology, 107, 154–160.CrossRefGoogle ScholarPubMed
Tedeschi, R.G. & Calhoun, L.G. (2004). Posttraumatic growth: conceptual foundations and empirical evidence. Psychological Inquiry, 15, 1–18.CrossRefGoogle Scholar
Van, derKolk, B.A. & McFarlane, A.C. (1996). The black hole of trauma. In: Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body, and Society. Van der Kolk, B.A., McFarlane, A.D. & Weisaeth, L. (eds.), pp. 3–23. New York: Guilford Press.Google Scholar
Ware, J. & Sherbourne, C. (1992). The MOS 36-item Short-Form Health Survey (SF-36): I. Conceptual framework and item selection. Medical Care, 30, 473–483.CrossRefGoogle ScholarPubMed
Watson, C. (1990). Psychometric posttraumatic stress disorder measurement techniques: A review. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 2, 460–469.CrossRefGoogle Scholar
Weathers, F.W., Litz, B.T., Herman, D.S., et al. (1993). The PTSD Checklist (PCL): Reliability, validity, and diagnostic utility. Presented at the Annual Meeting of International Society for Traumatic Stress Studies, San Antonio, Texas, October.Google Scholar
Yap, K.Y–L, Tay, W.L., Chui, W.K., et al. (2011). Clinically relevant drug interactions between anticancer drugs and psychotropic agents. European Journal of Cancer Care, 20, 6–32.CrossRefGoogle ScholarPubMed