Traumatic stress in acute leukemia

• Published in: Psycho-oncology (Chichester, England) England), 2013-02, Vol.22 (2), p.299-307
• Main Authors: Rodin, Gary, Yuen, Dora, Mischitelle, Ashley, Minden, Mark D, Brandwein, Joseph, Schimmer, Aaron, Marmar, Charles, Gagliese, Lucia, Lo, Christopher, Rydall, Anne, Zimmermann, Camilla
• Format: Article
• Language: English
• Subjects: acute leukemia; Adult; Aged; Canada; cancer; Female; hematological malignancies; Humans; Leukaemia; Leukemia; Leukemia, Myeloid, Acute - psychology; Male; Mental health care; Middle Aged; Morbidity; Mortality; Pain - psychology; Physical symptoms; Post traumatic stress disorder; Posttraumatic stress disorder; Precursor Cell Lymphoblastic Leukemia-Lymphoma - psychology; Professional-Patient Relations; psychosocial oncology; Regression Analysis; Severity of Illness Index; Stress; Stress Disorders, Post-Traumatic - psychology; supportive care; Surveys and Questionnaires; Symptoms; Traumatic stress
• ISSN: 1057-9249; 1099-1611
• DOI: 10.1002/pon.2092

Objective Acute leukemia is a condition with an acute onset that is associated with considerable morbidity and mortality. However, the psychological impact of this life‐threatening condition and its intensive treatment has not been systematically examined. In the present study, we investigate the prevalence and correlates of post‐traumatic stress symptoms in this population. Methods Patients with acute myeloid, lymphocytic, and promyelocytic leukemia who were newly diagnosed, recently relapsed, or treatment failures were recruited at a comprehensive cancer center in Toronto, Canada. Participants completed the Stanford Acute Stress Reaction Questionnaire, Memorial Symptom Assessment Scale, CARES Medical Interaction Subscale, and other psychosocial measures. A multivariate regression analysis was used to assess independent predictors of post‐traumatic stress symptoms. Results Of the 205 participants, 58% were male, mean age was 50.1 ± 15.4 years, 86% were recently diagnosed, and 94% were receiving active treatment. The mean Stanford Acute Stress Reaction Questionnaire score was 30.2 ± 22.5, with 27 of 200 (14%) patients meeting criteria for acute stress disorder and 36 (18%) for subsyndromal acute stress disorder. Post‐traumatic stress symptoms were associated with more physical symptoms, physical symptom distress, attachment anxiety, and perceived difficulty communicating with health‐care providers, and poorer spiritual well‐being (all p