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Acute stress in patients with brain cancer during primary care

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Abstract

Purpose

This study investigated whether diagnosis and neurosurgical removal of a brain tumour induced Acute Stress Disorder (ASD) in adults. We also aimed to identify factors associated with the development of ASD in this specific patient group and setting.

Methods

Forty-seven consecutive patients with intracranial neoplasms completed a variety of self-report questionnaires and underwent a structured clinical interview (SCID) within the first 4 weeks after tumour detection on average 1 week after neurosurgical treatment. Moreover, the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), A1 and A2 criterion and thus the characteristics of the traumatic event were explored in detail.

Results

ASD symptoms were common. Twenty-three percent of the patients met stringent criteria of ASD and another 4% suffered from subsyndromal ASD. Predisposing factors previously reported in literature with the exception of previous trauma could not be identified in this study (e.g., sex, age, intelligence).

Conclusion

It has been critically discussed whether the diagnosis of ASD is appropriate in cancer patients due to the often future-related nature of cancer-related traumatic events. The diagnosis of ASD was justified in the vast majority of affected patients due to the specific, acute and past traumatic experiences in concordance with the DSM and International Statistical Classification of Diseases and Related Health Problems (ICD) trauma definitions. Thus, ASD is a common and relevant psychiatric comorbidity in patients with brain tumours. Our data highlight both the need for the routine psychological assessment as well as of psychosocial support in this early treatment phase.

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Notes

  1. Premorbid IQ is calculated as follows: 82.08 + 0.22 × age + level of education + level of occupation + level of media use. For each of the last three predictors, one out of a different number of possible constants is selected according to detailed criteria.

References

  1. Goebel S, Stark A, Kaup L, von Harscher M, Mehdorn HM (2011) Distress in patients with newly diagnosed brain tumours. Psychooncology. doi:10.1002/pon.1858

  2. Gustafsson M, Edvardsson T, Ahlström G (2006) The relationship between function, quality of life and coping in patients with low-grade gliomas. Support Care Cancer 14:1205–1212

    Article  PubMed  Google Scholar 

  3. Keir ST, Calhoun-Eagan RD, Swartz JJ, Saleh OA, Friedman HS (2008) Screening for distress in patients with brain cancer using the nccn's rapid screening measure. Psychooncology 17:621–625

    Article  PubMed  Google Scholar 

  4. Kvale EA, Murthy R, Taylor R, Lee JY, Nabors LB (2009) Distress and quality of life in primary high-grade brain tumor patients. Support Care Cancer 17:793–799

    Article  PubMed  Google Scholar 

  5. Taphoorn MJ, Klein M (2004) Cognitive deficits in adult patients with brain tumours. Lancet Neurol 3:159–168

    Article  PubMed  Google Scholar 

  6. Hinz A, Krauss O, Hauss JP, Höckel M, Kortmann RD, Stolzenburg JU, Schwarz R (2009) Anxiety and depression in cancer patients compared with the general population. Eur J Cancer Care 19:522–529

    Article  Google Scholar 

  7. Zabora JR, BrintzenhofeSzoc KM, Curbow B, Hooker C, Piantadosi S (2001) The prevalence of psychological distress by cancer site. Psycho-Oncology 10:19–28

    Article  PubMed  CAS  Google Scholar 

  8. Mainio A, Hakko H, Timonen M, Niemelä A, Koivukangas J, Räsänen P (2005) Depression in relation to survival among neurosurgical patients with primary brain tumor: a 5-year follow-up study. Neurosurgery 56:1234–1242

    Article  PubMed  Google Scholar 

  9. Pringle A-A, Taylor R, Whittle IR (1999) Anxiety and depression in patients with an intracranial neoplasm before and after tumour surgery. Br J Neurosurg 13:46–51

    Article  PubMed  CAS  Google Scholar 

  10. Janda M, Steginga S, Langbecker D, Dunn J, Walker D, Eakin E (2007) Quality of life among patients with a brain tumour and their carers. J Psychosom Res 63:617–623

    Article  PubMed  Google Scholar 

  11. Davies E, Higginson IJ (2003) Communication, information and support for adults with malignant cerebral glioma: a systematic literature review. Support Care Cancer 11:21–29

    PubMed  Google Scholar 

  12. Pace A, Metro G, Fabi A (2010) Supportive care in neurooncology. Curr Opin Oncol Aug 11:S1531–1703X

    Google Scholar 

  13. Trask PC (2004) Assessment of depression in cancer patients. J Natl Cancer Inst Monogr 32:80–92

    Article  PubMed  Google Scholar 

  14. Goebel S, von Harscher M, Mehdorn HM (2010) Comorbid mental disorders and psychosocial distress in patients with brain tumours and their spouses in the early treatment phase. Support Care Cancer. doi:10.1007/s00520-010-1021-8

  15. First MB, Spitzer RL, Gibbon M, Williams JBW (1996) Structured clinical interview for DSM-IV Axis I disorders — clinician version. American Psychiatric Press, New York

    Google Scholar 

  16. Wittchen HU, Zaudig M, Fydrich T (1997) Skid. Strukturiertes interview für DSM IV. Achse I und II. Handanweisung. Hogrefe, Göttingen

  17. Kangas M, Henry JL, Bryant RA (2002) Posttraumatic stress disorder following cancer: a conceptual and empirical review. Clin Psychol Rev 22:499–524

    Article  PubMed  Google Scholar 

  18. Kangas M, Henry JL, Bryant RA (2005) The relationship between acute stress disorder and posttraumatic stress disorder following cancer. J Consult Clin Psychol 73:360–364

    Article  PubMed  Google Scholar 

  19. McGarvey EL, Canterbury RL, Koopman C, Clavet GJ, Cohen R, Largay K, Spiegler D (1998) Acute stress disorder following diagnosis of cancer. Int J Rehab Health 4:1–15

    Article  Google Scholar 

  20. Mehnert A, Koch U (2007) Prevalence of acute and post-traumatic stress disorder and comorbid mental disorders in breast cancer patients during primary cancer care: a prospective study. Psycho-Oncology 16:181–188

    Article  PubMed  Google Scholar 

  21. Huber W, Poeck K, Weninger D, Willmes K (1983) Der Aachener Aphasie Test (AAT). Hogrefe, Göttingen

    Google Scholar 

  22. Folstein MF, Folstein SE, McHugh PR (1975) "Mini-mental-state": A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198

    Article  PubMed  CAS  Google Scholar 

  23. Blake DD, Nagey LM, Kaloupek DG, Klauminzer G, Charney DS, Keane TM (1990) A clinician rating scale for assessing current and lifetime PTSD: The CAPS-1. Behav Ther 13:187–188

    Google Scholar 

  24. Schnyder U, Moergeli H (2002) German version of clinician-administered PTSD scale. J Traumatic Stress 15:487–492

    Article  Google Scholar 

  25. Weathers FW, Keane TM, Davidson JR (2001) Clinician-administered PTSD scale: a review of the first 10 years of research. Depress Anxiety 13:132–156

    Article  PubMed  CAS  Google Scholar 

  26. Bryant RA, Moulds ML, Guthrie RM (2000) Acute stress disorder scale: a self-report measure of acute stress disorder. Psychol Assess 12:61–68

    Article  PubMed  CAS  Google Scholar 

  27. Helfricht S, Landolt MA, Moergeli H, Hepp U, Wegener D, Schnyder U (2009) Psychometric evaluation and validation of the german version of the acute stress disorder scale across two distinct trauma populations. J Traumatic Stress 22:476–80

    Article  Google Scholar 

  28. Michal M, Sann U, Niebecker M, Lazanowsky C, Kernhof K, Aurich S, Overbeck G, Sierra M, Berrios GE (2004) The measurement of the depersonalisation–derealisation-syndrome with the German version of the Cambridge Depersonalisation Scale (CDS). Psychother Psychosom Med Psychol 54:367–374

    Article  PubMed  Google Scholar 

  29. Sierra M, Berrios GE (2000) The Cambridge Depersonalization Scale: a new instrument for the measurement of depersonalization. Psychiatry Res 93:153–164

    Article  PubMed  CAS  Google Scholar 

  30. Maercker A, Schützwohl M (1998) Erfassung von psychischen belastungsfolgen: Die impact of event skala — revidierte version (IES-R). Diagnostica 44:130–141

    Google Scholar 

  31. Weiss DS, Marmar CR (1996) The impact of event scale—revised. In: Wilson JP, Keane TM (eds) Assessing psychological trauma and PTSD. Guildford Press, New York

    Google Scholar 

  32. Creamer M, Bell R, Failla S (2003) Psychometric properties of the impact of event scale—revised. Behav Res Ther 41:1489–1496

    Article  PubMed  Google Scholar 

  33. Foa EB (1997) Posttraumatic stress diagnostic scale (PDS). Pearson, San Antonio

    Google Scholar 

  34. Herrmann C, Buss U, Snaith RP (1995) HADS-D—Hospital Anxiety and Depression Scale—deutsche version: Ein fragebogen zur erfassung von angst und depressivität in der somatischen medizin Huber, Bern

  35. Zigmond AS, Snaith RP (1983) The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 67:361–370

    Article  PubMed  CAS  Google Scholar 

  36. Leplow B, Friege L (1998) Eine sozialformel zur schätzung der prämorbiden intelligenz. Zeitschr Klin Psychol 27:1–8

    Google Scholar 

  37. Barona A, Chastian RL (1986) An improved estimate of premorbid IQ for blacks and whites on the WAIS-R. Int J Clin Neuropsychol 8:169–173

    Google Scholar 

  38. Wechsler D (1987) Wechsler Memory Scale—Revised. The Psychological Corporation, San Antonio

    Google Scholar 

  39. Tombaugh TN (2004) Trail Making Test A and B: Normative data stratified by age and education. Arch Clin Neuropsychol 19:203–214

    Article  PubMed  Google Scholar 

  40. Benton AL, Kd H (1989) Multilingual aphasia examination. AJA Associates, Iowa City

    Google Scholar 

  41. Warrington EK, James M (1992) Testbatterie für visuelle objekt- und raumwahrnehmung (vosp). Thames Valley Test Company, Bury St Edmunds

  42. Osterrieth PA (1944) Le test de copie d'une figure complexe. Arch Psychol 30:206–356

    Google Scholar 

  43. Buschke H, Fuld PA (1974) Evaluation of storage, retention, and retrieval in disordered memory and learning. Neurology 11:1019–1025

    Article  Google Scholar 

  44. Faul F, Erdfelder E, Buchner A, Lang A-G (2007) Statistical poweranalyses using g*power 3.1: tests for correlation and regression analyses. Behav Res Methods 41:1149–1160

    Article  Google Scholar 

  45. Schützwohl M, Maercker A (1999) Effects of varying diagnostic criteria for posttraumatic stress disorder are endorsing the concept of partial PTSD. J Traumatic Stress 12:155–165

    Article  Google Scholar 

  46. Lagarde G, Doyon J, Brunet A (2010) Memory and executive dysfunctions associated with acute posttraumatic stress disorder. Psychiatry Res 177:144–149

    Article  PubMed  Google Scholar 

  47. Quin S, Hermans EJ, van Marle HJ, Luo J, Fernandez G (2009) Acute psychological stress reduces working memory-related activity in the dorsolateral prefrontal cortex. Biol Psychiatry 66:25–32

    Article  Google Scholar 

  48. Danckwerts A, Leathen J (2003) Questioning the link between ptsd and cognitive dysfunction. Neuropsychol Rev 13:221–235

    Article  PubMed  Google Scholar 

  49. Kangas M, Henry JL, Bryant RA (2007) Correlates of acute stress disorder in cancer patients. J Traumatic Stress 20:325–334

    Article  Google Scholar 

  50. Horowitz M, Wilner N, Alvarez W (1979) Impact of event scale: a measure of subjective stress. Psychosom Med 41:209–218

    PubMed  CAS  Google Scholar 

  51. Carpenter KM, Fowler JM, Maxwell GL, Andersen BL (2010) Direct and buffering effects of social support among gynecologic cancer survivors. Ann Behav Med. doi:10.1007/s12160-010-9160-1

  52. Tedstone JE, Tarrier N (2003) Posttraumatic stress disorder following medical illness and treatment. Clin Psychol Rev 23:409–448

    Article  PubMed  Google Scholar 

  53. Mitchell AJ (2010) Short screening tools for cancer-related distress: a review and diagnostic validity meta-analysis. J Natl Compr Cancer Netw 8:487–494

    Google Scholar 

  54. Goebel S, Mehdorn HM (in press) The measure of psychological distress in patients with intracranial tumours: The nccn distress thermometer. J Neurooncol

  55. NCCN (2003) Distress management clinical practice guidelines. J Natl Compr Cancer Netw 1:344–374

    Google Scholar 

  56. Davidson JR (2000) Trauma: the impact of post-traumatic stress disorder. J Psychopharmacol 14(2Suppl1):S5–S12

    PubMed  CAS  Google Scholar 

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Conflict of interest

This study was not funded. The authors have full control of all primary data and agree to allow the journal to review the data if requested. There are no conflict of interests and no financial disclosures by any of the authors.

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Authors and Affiliations

  1. Department of Neurosurgery, University Hospital Schleswig-Holstein, Arnold-Heller-Str. 3, 24105, Kiel, Germany

    Simone Goebel & H. Maximilian Mehdorn

  2. Department of Medical Psychology and Medical Sociology, University Hospital Schleswig-Holstein, Diesterwegstr. 10-12, 24113, Kiel, Germany

    Hans Strenge

Authors
  1. Simone Goebel
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  2. Hans Strenge
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  3. H. Maximilian Mehdorn
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Correspondence to Simone Goebel.

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Goebel, S., Strenge, H. & Mehdorn, H.M. Acute stress in patients with brain cancer during primary care. Support Care Cancer 20, 1425–1434 (2012). https://doi.org/10.1007/s00520-011-1225-6

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