A systematic literature review exploring the prevalence of post-traumatic stress disorder and the role played by stress and traumatic stress in breast cancer diagnosis and trajectory.
A systematic literature review exploring the prevalence of post-traumatic stress disorder and the role played by stress and traumatic stress in breast cancer diagnosis and trajectory.
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DOI：
10.2147/bctt.s111101
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Pravettoni G
中科院分区：
文献类型：
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作者：
Arnaboldi P;Riva S;Crico C;Pravettoni G
压力作为与乳腺癌相关的心身因素已被广泛研究。本研究旨在通过仔细查阅有关乳腺癌幸存者的文献，综述创伤后应激障碍(PTSD)的患病率、其相关的危险因素、预测因素在其早期诊断/预防中的作用、共同治疗的意义以及压力可能影响癌症风险的潜在联系。作者系统地回顾了2002年至2016年发表的与创伤后应激障碍、乳腺癌和创伤后应激障碍以及乳腺癌和压力有关的研究。创伤后应激障碍的患病率在0%至32.3%之间，主要与疾病阶段、疾病阶段和检测患病率所采用的工具有关。当临床医生使用创伤后应激障碍量表时，观察到更高的百分比。关于与创伤后应激障碍相关的风险因素，迄今尚未达成共识；较年轻的年龄、中东发病率较高的地理出生地以及家族或亲属背景中有过癌症诊断的唯一变量被一致认为与较高的创伤后应激障碍发病率有关。C型人格可以被认为是一个危险因素，加上低社会支持。鉴于创伤后应激障碍对认知、社交、工作相关和身体功能的影响，癌症和创伤后应激障碍的联合治疗是必要的，并且必须从多学科的角度，包括对卫生保健专业人员进行与创伤后应激障碍患者的沟通和关系问题的具体培训。然而，即使在应激性生活事件和乳腺癌发病率之间发现了显著的相关性，也很难明确地证明乳腺癌中存在痛苦的含义。对于未来，克服方法的异质性是一个主要关注点。即使没有达到精神疾病诊断和统计手册的所有标准，疗效研究也可以在评估共同治疗乳腺癌和创伤后应激症状的效果时有所帮助。
Stress has been extensively studied as a psychosomatic factor associated with breast cancer. This study aims to review the prevalence of post-traumatic stress disorder (PTSD), its associated risk factors, the role of predicting factors for its early diagnosis/prevention, the implications for co-treatment, and the potential links by which stress could impact cancer risk, by closely examining the literature on breast cancer survivors. The authors systematically reviewed studies published from 2002 to 2016 pertaining to PTSD, breast cancer and PTSD, and breast cancer and stress. The prevalence of PTSD varies between 0% and 32.3% mainly as regards the disease phase, the stage of disease, and the instruments adopted to detect prevalence. Higher percentages were observed when the Clinician Administered PTSD Scale was administered. In regard to PTSD-associated risk factors, no consensus has been reached to date; younger age, geographic provenance with higher prevalence in the Middle East, and the presence of previous cancer diagnosis in the family or relational background emerged as the only variables that were unanimously found to be associated with higher PTSD prevalence. Type C personality can be considered a risk factor, together with low social support. In light of the impact of PTSD on cognitive, social, work-related, and physical functioning, co-treatment of cancer and PTSD is warranted and a multidisciplinary perspective including specific training for health care professionals in communication and relational issues with PTSD patients is mandatory. However, even though a significant correlation was found between stressful life events and breast cancer incidence, an unequivocal implication of distress in breast cancer is hard to demonstrate. For the future, overcoming the methodological heterogeneity represents one main focus. Efficacy studies could help when evaluating the effect of co-treating breast cancer and post-traumatic stress symptoms, even if all the criteria for a Diagnostic and Statistical Manual of Mental Disorders diagnosis are not fulfilled.