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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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