Traumatic stress in patients with acute leukemia: A prospective cohort study

Absract

Objective

Acute leukemia (AL) is associated with an immediate threat to life, an unpredictable clinical course, and substantial physical suffering. Traumatic stress symptoms that may meet criteria for acute stress disorder (ASD) may be common and disabling in this context, but have received little clinical attention. We investigated the incidence over time and risk factors for traumatic stress symptoms and ASD in the 3 months following diagnosis or relapse of AL.

Methods

Individuals with AL were recruited at a tertiary cancer centre in Canada within one month of diagnosis or relapse. Participants (N=230) completed self-report measures, including the Stanford Acute Stress Reaction Questionnaire, at baseline and monthly over 3 months. The incidence of traumatic stress symptoms over time was examined and a generalized logistic model was used to identify factors associated with ASD.

Results

Participants were 60% male, with a mean age of 48.9±15.2 years. Symptoms of ASD were identified in 24.3% of participants at baseline. Of these participants, ASD was identified in 37.3% at one follow-up and in 55.3% at ≥2 follow-ups. ASD was associated with having young children, being unmarried, acute lymphocytic leukemia (ALL), and greater physical symptom burden. Persistent or recurrent ASD was associated with female sex, ALL, greater attachment anxiety, less spiritual well-being, and less satisfactory patient-clinician communication.

Conclusions

Symptoms of ASD are common and often persist or recur following diagnosis or relapse of AL. Research is urgently needed to determine the impact of interventions to prevent and treat psychological distress in this population.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2tx82HQ
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