Study Finds Many Patients With Breast Cancer Develop Symptoms of Post-Traumatic Stress Disorder; Symptoms Diminished Over 1 Year

Key Points

  • During the interval between diagnosis of cancer and the initiation of treatment, 82.5% of all patients were found to exhibit symptoms of post-traumatic stress disorder, such as recurrent and intrusive reminders of the experiences associated with cancer, feelings of detachment and emotional numbness, increased arousal, sudden outbursts of anger, and an exaggerated startle response.
  • Although a full diagnosis of post-traumatic stress disorder was found in only 2% of patients 1 year after the cancer diagnosis, more than half (57.3%) continued to display one or more symptoms of the disorder at that point.
  • When patients who had already had a traumatic experience—such as a serious accident or a violent assault—prior to the development of malignancy, some 40% of them rated having breast cancer as the more severe traumatic event.

According to a study led by Ludwig-Maximilians-Universitaet (LMU) researchers, a majority of patients diagnosed with breast cancer go on to develop symptoms of post-traumatic stress disorder, and in most of these cases, symptoms persist for at least a year. These findings were published by Voigt et al in Psycho-Oncology.

The majority of women suffering from breast cancer develop symptoms of post-traumatic stress in the months following receipt of the diagnosis. The latest results of the Cognicares study, led by Kerstin Hermelink, PhD, of the Breast Cancer Center in the Department of Gynecology and Obstetrics at the LMU Medical Center, show that such symptoms can still be detected a year after patients have been informed of their condition.

Study Findings

In the multicenter Cognicares study, Dr. Hermelink and her team studied a group of 166 patients who had been newly diagnosed with breast cancer. Over the course of the following year, the participants were assessed at three specific time-points for the presence of clinically significant symptoms of post-traumatic stress disorder. The results were then compared with those for a control group of patients without a cancer diagnosis.

During the interval between diagnosis of cancer and the initiation of treatment, 82.5% of all patients were found to exhibit symptoms of post-traumatic stress disorder, such as recurrent and intrusive reminders of the experiences associated with cancer, feelings of detachment and emotional numbness, increased arousal, sudden outbursts of anger, and an exaggerated startle response. Although a full diagnosis of post-traumatic stress disorder was found in only 2% of patients 1 year after the cancer diagnosis, more than half (57.3%) continued to display one or more symptoms of the disorder at that point. In contrast, the rate of post-traumatic stress disorder symptoms due to other traumatic events was very low in the controls and the patients alike.

“That the high level of stress should persist for such a long time is particularly striking,” said Dr. Hermelink. Indeed, the severity of the psychological and emotional impact of the cancer diagnosis is underlined by another result reported in the study. When patients who had already had a traumatic experience—such as a serious accident or a violent assault—prior to the development of malignancy, some 40% of them rated having breast cancer as the more severe traumatic event.

Cognicares Background

“Cognicares is one of the very few longitudinal studies of traumatic stress associated with breast cancer,” said Dr. Hermelink. Moreover, the data on which the study is based come from diagnostic interviews conducted by psychologists, and not from self-assessments. Only patients who were free of metastatic disease, and could therefore hope to be permanently cured, were recruited into the study, and women who had a history of psychiatric disease were excluded. “Indeed, we assume that the study is likely to somewhat underestimate the true incidence of post-traumatic stress symptoms in breast cancer patients,” Dr. Hermelink added.

The researchers also set out to identify factors that could account for the varying incidence and the varying duration of symptoms of post-traumatic stress disorder among their study population. “Neither the type of surgery nor receipt of chemotherapy had any significant effect on either of these variables, but a high level of education did have a favorable impact. A university education is evidently a marker for resources that enable patients to recover more rapidly from the psychological stresses associated with a diagnosis of breast cancer,” Dr. Hermelink explained.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


Advertisement

Advertisement



Advertisement