Symptoms of posttraumatic stress in young adult survivors of childhood cancer
Symptoms of posttraumatic stress in young adult survivors of childhood cancer
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DOI：
10.1200/jco.2000.18.24.4060
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发表时间：
2000-12-15
影响因子：
45.3
通讯作者：
Kazak, AE
中科院分区：
文献类型：
--
作者：
Hobbie, WL;Stuber, M;Kazak, AE
目的：研究创伤后应激症状在青壮年癌症幸存者中的患病率，以及创伤后应激与焦虑、适应、疾病和治疗的感知以及从肿瘤学记录中提取的医学数据之间的关系。患者和方法：78名接受过儿童癌症治疗的青壮年(年龄18-40岁)完成了问卷和精神病学访谈，评估创伤后应激、焦虑、对他们的疾病和治疗的感知以及心理困扰的症状。结果：在患者样本中，20.5%的患者自治疗结束以来在某些方面符合美国精神病学协会创伤后应激障碍(PTSD)的诊断和统计手册标准。报告了临床上显著的侵入性(9%)和回避性(16.7%)症状，参与者还报告了更高的状态和特质焦虑。患有创伤后应激障碍的参与者报告说，与没有创伤后应激障碍的人相比，他们感觉到更高的当前生命威胁，更多的熏香治疗史，以及更高的(和临床上有意义的)心理困扰水平。结论：在这个样本中，五分之一的年轻儿童癌症幸存者符合创伤后应激障碍的诊断标准，并报告了显著的侵扰和回避症状。与其他样本一样，年轻成年幸存者的创伤后应激障碍与焦虑和其他心理困扰有关。与更客观的医学数据相比，幸存者对治疗及其效果的看法与创伤后应激更密切相关。这些数据表明，与癌症相关的创伤后应激可能出现在青年时期，并可能影响发展里程碑的实现和对医疗保健的定向。J Clin Oncol18：4060-4066。(C)2000年，由美国临床肿瘤学会提供。
Purpose: This study assessed the prevalence of posttraumatic stress symptoms in young adult survivors of childhood cancer and the association of posttraumatic Stress with anxiety, adjustment, perceptions of illness and treatment, and medical data extracted from oncology records.Patients and Methods: Seventy-eight young adults (ages 18 to 40 years) who had been treated for childhood cancer completed questionnaires and psychiatric interviews assessing posttraumatic stress, anxiety, perceptions of their illness and treatment, and symptoms of psychologic distress. Delta on treatment intensity and severity of medical late effects were collected via chart review.Results: Of the patient sample, 20.5% met American psychiatric Association Diagnostic and Statistical Manual criteria for posttraumatic stress disorder (PTSD) at some paint since the end of their treatment. Clinically significant levels of intrusive (9%) and avoidant (16.7%) symptoms were reported, Participants also reported elevated state and trait anxiety. Participants with PTSD reported higher perceived current life threat, more incense treatment histories, and higher (and clinically significant) levels of psychologic distress than those who did not have PTSD.Conclusion: One-fifth of this sample of young adult survivors of childhood cancer met criteria for a diagnosis of PTSD, with clinically significant symptoms of intrusion and avoidance reported. As in other samples, PTSD in young adult survivors was associated with anxiety and other psychologic distress. Survivors' perceptions of treatment and its effects were more highly associated with posttraumatic stress than were more objective medical data. The data suggest that cancer-related posttraumatic stress may emerge in young adulthood and may affect the achievement of developmental milestones and orientation toward health care. J Clin Oncol 18:4060-4066. (C) 2000 by American Society of Clinical Oncology.