Acute stress in patients with brain cancer during primary care

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. 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.

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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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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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Keywords

  • Intracranial tumour
  • Acute stress
  • Mental disorder
  • Patients
  • Primary care