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Posttraumatic stress disorder symptomatology in the course of allogeneic HSCT: a prospective study

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Abstract

Purpose

Despite the life-threatening character of allogeneic hematopoietic stem cell transplantation (allogeneic HSCT), very few longitudinal research exists on posttraumatic stress disorder (PTSD) symptomatology in this patient group. We investigated prevalence, temporal course and predictors of PTSD symptomatology in this population.

Methods

Patients were assessed before conditioning (T0), 100 days (T1), and 12 months after HSCT (T2). PTSD symptomatology was measured with the PTSD Checklist—Civilian Version. We conducted multilevel modeling and multiple regression analyses.

Results

Two hundred thirty-nine patients participated at baseline, 150 at T1, and 102 at T2. Up to 15 % met the criteria for PTSD at least once during the course of assessment. Fifty-two percent showed diagnostic relevant levels of intrusion, 30 % of avoidance, and 33 % of arousal at least once. Apart from arousal, which increased between T0 and T1 (γ = 0.56, p = 0.03), no other severity score significantly differed between time points. Being impaired by pain (γ = 2.89, p < 0.01), pain level (γ = 0.63, p = 0.02), and being female (γ = 3.81, p < 0.01) emerged as significant predictors of PTSD symptomatology when taking into account all time points. Acute plus chronic graft-versus-host-disease and longer hospital stay predicted PTSD symptomatology at T2 (γ = 3.39, p = 0.04; γ = 0.1, p = 0.03).

Conclusions

A considerable number of patients undergoing allogeneic HSCT met the criteria for PTSD. PTSD symptomatology is prominent at all assessment points. Burden of pain, being female, and medical complications are risk factors for elevated levels of PTSD symptomatology.

Implications for cancer survivors

Psychological support should be offered not only after treatment but also in the long-term and even before HSCT. Professionals should be aware of the psychological consequences accompanied by pain and complications.

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Authors and Affiliations

  1. Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany

    Peter Esser, Katharina Kuba, Heide Götze & Anja Mehnert

  2. Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20251, Hamburg, Germany

    Angela Scherwath, Lena Schirmer, Frank Schulz-Kindermann, Uwe Koch & Anja Mehnert

  3. Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany

    Andreas Dinkel

  4. Department of Medical Psychology and Medical Sociology, University Hospital Carl Gustav Carus, Technical University of Dresden, Fetscherstraße 74, 01307, Dresden, Germany

    Friedrich Balck

  5. Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20251, Hamburg, Germany

    Nicolaus Kröger

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  1. Peter Esser
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  2. Katharina Kuba
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  8. Uwe Koch
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Corresponding author

Correspondence to Peter Esser.

Ethics declarations

The research was approved by the local ethics committees or the institutional review boards. Prior to participation, all patients provided written informed consent.

Funding

This study was funded by the José Carreras Leukämie-Stiftung e.V. (grant nos. DJCLS R 04/29pf and DJCLS R 07/37pf).

Conflict of interest

The funding source was not involved in any stage of the research process. The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Esser, P., Kuba, K., Scherwath, A. et al. Posttraumatic stress disorder symptomatology in the course of allogeneic HSCT: a prospective study. J Cancer Surviv 11, 203–210 (2017). https://doi.org/10.1007/s11764-016-0579-7

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  • DOI: https://doi.org/10.1007/s11764-016-0579-7

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