Major Depression, Adjustment Disorders, and Post-Traumatic Stress Disorder in Terminally Ill Cancer Patients: Associated and Predictive Factors

2004 ◽  
Vol 22 (10) ◽  
pp. 1957-1965 ◽  
Author(s):  
Tatsuo Akechi ◽  
Toru Okuyama ◽  
Yuriko Sugawara ◽  
Tomohito Nakano ◽  
Yasuo Shima ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Cancer Patients ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Terminally Ill ◽  
Anxiety And Depression ◽  
Post Traumatic Stress ◽  
Terminally Ill Cancer Patients ◽  
Post Traumatic

Purpose Few studies have been conducted to elucidate the psychological distress of terminally ill cancer patients. This study attempted to determine the prevalence of adjustment disorders (AD), major depression (MD), and post-traumatic stress disorder (PTSD) among terminally ill cancer patients, to identify factors that contribute to them, and to determine how they change longitudinally. Patients and Methods Consecutive terminally ill cancer patients were recruited. Patients were assessed for psychiatric disorders by structured clinical interview twice: once at the time of their registration with a palliative care unit (baseline), and again at the time of their palliative care unit admission (follow-up). Possible contributed biomedical and psychosocial factors were evaluated. Results The proportions of patients diagnosed with AD, MD, and PTSD at baseline (n = 209) were 16.3%, 6.7%, and 0% respectively, whereas at follow-up (n = 85), 10.6% were diagnosed with AD and 11.8% with MD. Lower performance status, concern about being a burden to others, and lower satisfaction with social support were significantly associated with AD/MD at baseline. There were changes in the diagnosis of AD and MD in 30.6% of the patients. Only the Hospital Anxiety and Depression Scale at the baseline was significantly predictive of AD/MD at follow-up. Conclusion The factors underlying psychological distress are multifactorial. Early intervention to treat subclinical anxiety and depression may prevent subsequent psychological distress.

Psychological treatments for post-traumatic stress disorder, anxiety and depression following major physical civilian trauma: A systematic review and meta-analysis

Trauma ◽  
2021 ◽  
pp. 146040862110261
Author(s):  
Arham Qureshi ◽  
Edward Dickenson ◽  
Peter Wall
Keyword(s):  
Usual Care ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Anxiety And Depression ◽  
Wait List ◽  
Post Traumatic Stress ◽  
Psychological Treatments ◽  
Civilian Trauma ◽  
Post Traumatic ◽  
Better Than

Introduction Approximately 16% of the world’s burden of disease is attributable to traumatic injury. Psychological symptoms, including post-traumatic stress disorder (PTSD), are prevalent in this population and impact recovery from physical injury. Nevertheless, mental health has not been considered to the same degree as physical health. Psychological interventions are used widely as treatments for PTSD. Methods Systematic searches of computerised databases were conducted. Randomised controlled trials of psychological treatments for PTSD following major physical civilian trauma were included. The main outcome measure was clinician-assessed symptoms of PTSD (CAPS), with findings for anxiety and depression also reported. Included studies data were extracted and entered using RevMan 5.3 software. Quality assessments were performed, and data were analysed for summary effects. Results 10 studies were included. With regard to CAPS <6 months, individual CBT did significantly better than usual care/wait list (SMD (95% CI) = −1.24 [−1.82, −0.67]) and non-CBT treatments (SMD (95% CI) = −1.32 [−2.64, −0.04]). Non-CBT treatments were not significantly better than usual care/wait list (SMD (95% CI) −1.40 [−2.91, 0.11]). CBT was superior to usual care/wait list for reducing depressive (SMD (95% CI) −0.67 [−0.98, −0.37]) and anxiety (SMD (95% CI) −0.70 [−1.22, −0.18]) symptoms both in the shorter and longer term. Conclusion Individual CBT was superior to wait list/usual care, and there was limited evidence for non-CBT treatments in reducing clinician and self-rated PTSD, depressive and anxiety symptoms in the shorter term; however, the latter comparison was based on few studies with small sample sizes. Longer-term effects of treatments remain uncertain. There is a need for adequately powered RCTs investigating PTSD treatments following major physical civilian trauma in the longer term. There was considerable heterogeneity in the studies, so care must be taken in interpreting the results of this review.

scholarly journals The association between body mass index and recovery from post-traumatic stress disorder after the nuclear accident in Fukushima

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Masato Nagai ◽  
Tetsuya Ohira ◽  
Masaharu Maeda ◽  
Seiji Yasumura ◽  
Itaru Miura ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Error Variance ◽  
Normal Weight ◽  
Post Traumatic Stress ◽  
Post Traumatic

AbstractPost-traumatic stress disorder (PTSD) and obesity share common risk factors; however, the effect of obesity on recovery from PTSD has not been assessed. We examined the association between body mass index (BMI) and recovery from PTSD after the Great East Japan Earthquake. We analyzed 4356 men and women with probable PTSD aged ≥ 16 years who were living in evacuation zones owing to the radiation accident in Fukushima, Japan. Recovery from probable PTSD was defined as Post-traumatic Stress Disorder Checklist-specific scores < 44. Using Poisson regression with robust error variance adjusted for confounders, we compared the prevalence ratios (PRs) and 95% confidence intervals (CIs) for this outcome in 2013 and 2014. Compared with point estimates for normal weight (BMI: 18.5–24.9 kg/m2), especially in 2013, those for underweight (BMI: < 18.5 kg/m2) and obesity (BMI: ≥ 30.0 kg/m2) tended to slightly increase and decrease, respectively, for recovery from probable PTSD. The multivariate-adjusted PRs (95% CIs) for underweight and obesity were 1.08 (0.88–1.33) and 0.85 (0.68–1.06), respectively, in 2013 and 1.02 (0.82–1.26) and 0.87 (0.69–1.09), respectively, in 2014. The results of the present study showed that obesity may be a useful predictor for probable PTSD recovery. Obese victims with PTSD would require more intensive support and careful follow-up for recovery.

scholarly journals Treatment of adult post-traumatic stress disorder using a future-oriented writing therapy approach

2009 ◽  
Vol 2 (4) ◽  
pp. 243-255 ◽  
Author(s):  
Reginald D. V. Nixon ◽  
Leonard W. Kling
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Expressive Writing ◽  
Stress Disorder ◽  
Post Treatment ◽  
Future Research ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
Ptsd Severity

AbstractThe aim of this pilot study was to test whether a future-oriented expressive writing intervention is able to reduce post-traumatic stress disorder (PTSD) severity and associated symptoms such as depression and unhelpful trauma-related beliefs. In an uncontrolled pre-/ post-design participants attended 8 weeks of manualized therapy. Assessment was undertaken pre- and post-treatment, and participants also completed a 3-month follow-up assessment. Of the 17 participants who began therapy, 13 were treatment completers. Results indicated a significant decrease in PTSD severity, depression and unhelpful trauma-related cognitions from pre- to post-treatment and at 3-month follow-up. Clinically meaningful change was more modest; however, three participants reported PTSD remission at 3-month follow-up. It is concluded that expressive writing with a focus on achieving future goals and personal change may have some utility in reducing post-traumatic stress but future research will need to investigate this with greater methodological rigour before firm conclusions can be made.

scholarly journals Randomized Clinical Trial of Telephone-Administered Cognitive-Behavioral Therapy to Reduce Post-Traumatic Stress Disorder and Distress Symptoms After Hematopoietic Stem-Cell Transplantation

2010 ◽  
Vol 28 (23) ◽  
pp. 3754-3761 ◽  
Author(s):  
Katherine N. DuHamel ◽  
Catherine E. Mosher ◽  
Gary Winkel ◽  
Larissa E. Labay ◽  
Christine Rini ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Behavioral Therapy ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Hematopoietic Stem ◽  
General Distress ◽  
Distress Symptoms ◽  
Post Traumatic

Purpose A significant number of survivors of hematopoietic stem-cell transplantation (HSCT) report enduring adverse effects of treatment, including illness-related post-traumatic stress disorder (PTSD) symptoms and general distress. We report results of a randomized clinical trial that tested the effects of a 10-session, telephone-administered cognitive-behavioral therapy (CBT) intervention on PTSD, depression, and distress symptoms. Methods Survivors who had undergone HSCT 1 to 3 years earlier (N = 408) were assessed for study eligibility. Those who met study eligibility criteria (n = 89) completed a baseline assessment that included a clinical interview and self-report measures of PTSD symptoms (the primary outcome) and depression and general distress (the secondary outcomes). Next, they were randomly assigned to CBT or an assessment-only condition. Survivors in the CBT group completed 10 individual telephone-based CBT sessions (T-CBT) that included strategies to reduce PTSD symptoms, depression, and general distress. Follow-up assessments occurred at 6, 9, and 12 months after the baseline assessment. Results Linear mixed-model analyses revealed that, compared with HSCT survivors in the assessment-only condition, survivors who completed T-CBT reported fewer illness-related PTSD symptoms, including less avoidance (P < .001) and fewer intrusive thoughts (P < .05) as well as less general distress and fewer depressive symptoms (P < .05) even after controlling for potential demographic and medical covariates. These results were consistent across the three follow-up assessments. Conclusion A brief, telephone-administered CBT intervention developed for HSCT survivors is an efficacious treatment for reducing illness-related PTSD symptoms and general distress.

scholarly journals Psychological treatments for post-traumatic stress disorder in adults: a network meta-analysis

2020 ◽  
Vol 50 (4) ◽  
pp. 542-555 ◽  
Author(s):  
Ifigeneia Mavranezouli ◽  
Odette Megnin-Viggars ◽  
Caitlin Daly ◽  
Sofia Dias ◽  
Nicky J. Welton ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Post Treatment ◽  
Post Traumatic Stress ◽  
Psychological Treatments ◽  
Self Help ◽  
Remission Rates ◽  
Post Traumatic

AbstractBackgroundPost-traumatic stress disorder (PTSD) is a potentially chronic and disabling disorder affecting a significant minority of people exposed to trauma. Various psychological treatments have been shown to be effective, but their relative effects are not well established.MethodsWe undertook a systematic review and network meta-analyses of psychological interventions for adults with PTSD. Outcomes included PTSD symptom change scores post-treatment and at 1–4-month follow-up, and remission post-treatment.ResultsWe included 90 trials, 6560 individuals and 22 interventions. Evidence was of moderate-to-low quality. Eye movement desensitisation and reprocessing (EMDR) [standardised mean difference (SMD) −2.07; 95% credible interval (CrI) −2.70 to −1.44], combined somatic/cognitive therapies (SMD −1.69; 95% CrI −2.66 to −0.73), trauma-focused cognitive behavioural therapy (TF-CBT) (SMD −1.46; 95% CrI −1.87 to −1.05) and self-help with support (SMD −1.46; 95% CrI −2.33 to −0.59) appeared to be most effective at reducing PTSD symptoms post-treatment v. waitlist, followed by non-TF-CBT, TF-CBT combined with a selective serotonin reuptake inhibitor (SSRI), SSRIs, self-help without support and counselling. EMDR and TF-CBT showed sustained effects at 1–4-month follow-up. EMDR, TF-CBT, self-help with support and counselling improved remission rates post-treatment. Results for other interventions were either inconclusive or based on limited evidence.ConclusionsEMDR and TF-CBT appear to be most effective at reducing symptoms and improving remission rates in adults with PTSD. They are also effective at sustaining symptom improvements beyond treatment endpoint. Further research needs to explore the long-term comparative effectiveness of psychological therapies for adults with PTSD and also the impact of severity and complexity of PTSD on treatment outcomes.

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