Post-traumatic stress disorder and cancer.
Post-traumatic stress disorder and cancer.
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DOI：
10.1016/s2215-0366(17)30014-7
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发表时间：
2017-04
期刊：
影响因子：
--
通讯作者：
Spiegel D
中科院分区：
文献类型：
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作者：
Cordova MJ;Riba MB;Spiegel D
被诊断出患有癌症并接受治疗是高度紧张和潜在的创伤。大量文献评估了癌症相关创伤后应激障碍（PTSD）症状和诊断的患病率、预测因素和相关因素。在这篇癌症相关PTSD文献的定性综述中，我们强调了概念、方法和诊断问题，并确定了临床意义和未来研究的领域。在少数癌症患者及其家庭成员中记录了癌症相关的PTSD，与其他痛苦指数和生活质量降低呈正相关，并且有几个相关因素和风险因素（例如，既往创伤史，预先存在的精神疾病，社会支持不足）。关于癌症相关PTSD治疗的文献很少。现有的文献对癌症相关的PTSD使用DSM-IV-TR诊断标准;修订后的DSM-5 PTSD标准对评估癌症相关的痛苦有重要意义。应用PTSD诊断癌症患者的概念和方法论的理由进行了批评，重要的鉴别诊断的考虑因素应予以考虑。癌症患者的心理社会评估应包括仔细评估癌前诊断创伤和精神病史，诊断访谈应考虑并发症（如适应障碍）。癌症相关的PTSD的治疗应谨慎对待，并通过现有的基于证据的创伤性应激方法来了解。
Being diagnosed with and treated for cancer is highly stressful and potentially traumatic. An extensive literature has evaluated the prevalence, predictors, and correlates of cancer-related post-traumatic stress disorder (PTSD) symptoms and diagnoses. In this qualitative review of cancer-related PTSD literature, we highlight conceptual, methodological, and diagnostic issues, and identify clinical implications and areas for future research. Cancer-related PTSD has been documented in a minority of patients with cancer and their family members, is positively associated with other indices of distress and reduced quality of life, and has several correlates and risk factors (eg, prior trauma history, pre-existing psychiatric conditions, poor social support). The literature on treatment of cancer-related PTSD is sparse. Existing literature on cancer-related PTSD has used DSM-IV-TR diagnostic criteria; the revised DSM-5 PTSD criteria have important implications for the assessment of cancer-related distress. Application of PTSD diagnosis to patients with cancer has been critiqued on conceptual and methodological grounds, and important differential diagnosis considerations should be taken into account. Psychosocial assessment of patients with cancer should include careful evaluation of pre-cancer diagnosis trauma and psychiatric history, and diagnostic interviewing should consider concurrent conditions (eg, adjustment disorder). Treatment of cancer-related PTSD should be approached with caution and be informed by existing evidence-based approaches for traumatic stress.