Posttraumatic stress disorder after cancer diagnosis in adults: a meta-analysis

Samantha Swartzman (Lead / Corresponding author), Josephine Booth, Alastair Munro, Fabio Sani

Research output: Contribution to journalReview article

38 Citations (Scopus)
163 Downloads (Pure)

Abstract

Background: Since the introduction of serious illness as a potential traumatic stressor in the fourth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), research on the prevalence and predictors of post-traumatic stress disorder (PTSD) after cancer diagnosis has proliferated. Studies have reported widely varying estimates of the number of people with PTSD after cancer. The aim of this review is to synthesize quantitative data from studies reporting the proportion of people with PTSD among groups of cancer survivors.

Methods: We undertook a diversified literature search strategy and identified 120 samples from 110 sources reporting a proportion of cancer survivors with PTSD. Of these, eleven studies, containing twelve samples, reported estimates of PTSD in cancer survivors compared to matched controls.

Results: A random effects meta-analysis estimated the odds ratio as 1.66 (95% confidence interval: 1.09 to 2.53) for PTSD in cancer survivors compared to controls, although some of this apparent increase may have arisen from publication bias. Factors influencing the reported proportion of a post-cancer sample with PTSD included measurement type (clinical interview vs. self-report instrument), type of cancer, type of treatment, geographic region, whether the term “post-traumatic stress” was in the title or abstract, prior trauma, age, and time since diagnosis.

Conclusions: PTSD, diagnosed according to DSM-IV criteria, is more common in survivors of cancer than it is in the general population. Estimates of the occurrence of PTSD in patients with a history of cancer depend upon clinical and demographic factors, as well as upon study design.
Original languageEnglish
Pages (from-to)327-339
Number of pages12
JournalDepression and Anxiety
Volume34
Issue number4
Early online date28 Jul 2016
DOIs
Publication statusPublished - 1 Apr 2017

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Post-Traumatic Stress Disorders
Meta-Analysis
Survivors
Neoplasms
Diagnostic and Statistical Manual of Mental Disorders
Publication Bias
Self Report
Research Design
Odds Ratio
Demography
Confidence Intervals
Interviews
Wounds and Injuries

Keywords

  • epidemiology
  • meta-analysis
  • neoplasms
  • postraumatic
  • review
  • stress disorders
  • systematic

Cite this

Swartzman, Samantha ; Booth, Josephine ; Munro, Alastair ; Sani, Fabio. / Posttraumatic stress disorder after cancer diagnosis in adults : a meta-analysis. In: Depression and Anxiety. 2017 ; Vol. 34, No. 4. pp. 327-339.
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Posttraumatic stress disorder after cancer diagnosis in adults : a meta-analysis. / Swartzman, Samantha (Lead / Corresponding author); Booth, Josephine; Munro, Alastair; Sani, Fabio.

In: Depression and Anxiety, Vol. 34, No. 4, 01.04.2017, p. 327-339.

Research output: Contribution to journalReview article

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N2 - Background: Since the introduction of serious illness as a potential traumatic stressor in the fourth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), research on the prevalence and predictors of post-traumatic stress disorder (PTSD) after cancer diagnosis has proliferated. Studies have reported widely varying estimates of the number of people with PTSD after cancer. The aim of this review is to synthesize quantitative data from studies reporting the proportion of people with PTSD among groups of cancer survivors.Methods: We undertook a diversified literature search strategy and identified 120 samples from 110 sources reporting a proportion of cancer survivors with PTSD. Of these, eleven studies, containing twelve samples, reported estimates of PTSD in cancer survivors compared to matched controls.Results: A random effects meta-analysis estimated the odds ratio as 1.66 (95% confidence interval: 1.09 to 2.53) for PTSD in cancer survivors compared to controls, although some of this apparent increase may have arisen from publication bias. Factors influencing the reported proportion of a post-cancer sample with PTSD included measurement type (clinical interview vs. self-report instrument), type of cancer, type of treatment, geographic region, whether the term “post-traumatic stress” was in the title or abstract, prior trauma, age, and time since diagnosis.Conclusions: PTSD, diagnosed according to DSM-IV criteria, is more common in survivors of cancer than it is in the general population. Estimates of the occurrence of PTSD in patients with a history of cancer depend upon clinical and demographic factors, as well as upon study design.

AB - Background: Since the introduction of serious illness as a potential traumatic stressor in the fourth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), research on the prevalence and predictors of post-traumatic stress disorder (PTSD) after cancer diagnosis has proliferated. Studies have reported widely varying estimates of the number of people with PTSD after cancer. The aim of this review is to synthesize quantitative data from studies reporting the proportion of people with PTSD among groups of cancer survivors.Methods: We undertook a diversified literature search strategy and identified 120 samples from 110 sources reporting a proportion of cancer survivors with PTSD. Of these, eleven studies, containing twelve samples, reported estimates of PTSD in cancer survivors compared to matched controls.Results: A random effects meta-analysis estimated the odds ratio as 1.66 (95% confidence interval: 1.09 to 2.53) for PTSD in cancer survivors compared to controls, although some of this apparent increase may have arisen from publication bias. Factors influencing the reported proportion of a post-cancer sample with PTSD included measurement type (clinical interview vs. self-report instrument), type of cancer, type of treatment, geographic region, whether the term “post-traumatic stress” was in the title or abstract, prior trauma, age, and time since diagnosis.Conclusions: PTSD, diagnosed according to DSM-IV criteria, is more common in survivors of cancer than it is in the general population. Estimates of the occurrence of PTSD in patients with a history of cancer depend upon clinical and demographic factors, as well as upon study design.

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