PTSD: Cancer As Trauma

5. April 2011
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When looking at post-traumatic stress disorder (PTSD) one thinks of violence, accident or war, but hardly of physical illnesses such as cancer or Crohn's disease. Researchers have now taken a closer look at the consequences of serious illnesses.

Post Traumatic Stress Disorder is a response to traumatic events and typically manifests itself in symptoms such as obtrusive, recurring or stressful dreams and thoughts, sleep disturbances, irritability, nervousness, avoidance behavior, depression etc. The disorder occurs immediately or some time after a traumatic event, according to the definition.

Recent research focuses on physical conditions such as cancer and other serious chronic diseases as a cause of PTSD, since serious illnesses themselves and the associated diagnostic and therapeutic measures can take an emotional toll, which appears as a form of post traumatic stress. The U.S. National Cancer Institute for example fully informs those afflicted about PTSD in cancer cases.

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Chron’s is like a chronic trauma

That Crohn’s Disease is a potential cause of PTSD, which in turn has an extremely negative effect on the intestinal disease itself, is something that was revealed by a Swiss Cohort study on 597 patients with Crohn’s disease. To begin with, the study group under Ronald Känel of the Inselspital in Bern recorded the mental health of study participants on a post-traumatic stress scale, which contains 17 items and yields a maximum of 51 points. One in five patients reached the threshold of 15 points which means that a fifth of those examined reported of symptoms of a full-blown PTSD. How the PTSD affects the development of the disease was revealed in the subsequent eighteen-month investigation of the patients. The frequency of exacerbations , defined as flare-up of the disease, extraintestinal manifestations, complications, or lack of response to treatment increased with the level of PTSD points achieved.

Study participants with PTSD scores of 15 or more experienced four times higher likelihood of deterioration of their chronic bowel disease than those whose score was below this threshold. Compared with Crohn patients with scores of O in the PTSD data capture, there was even found to be a thirteenfold higher probability of exacerbation. Possible influencing factors such as disease duration, strictures , fistulas , medication needs, gender and age were taken into account.

Pay attention to PTSD symptoms

It was found that specific symptom clusters increase the risk of worsening the disease: these were mainly recurrent disease-related dreams or nightmares, avoidance behavior related to the disease and states of hyperarousal.

Post Traumatic Stress alters the hormonal and immune state, which may explain the negative impact on physical illness, the researchers said. Because PTSD often occurs in patients with Crohn’s disease and influences its progression, treating physicians should ask about symptoms of PTSD. In many cases, affected patients do not talk about their disease in order not to be confronted with it, according to the researchers. This avoidance behavior in combination with the lack of time in medical practice unknowingly fosters the poor progression of the disease.

Specifically-targeted questions searching for repeated experience, avoidance behavior and symptoms of agitation, such as anxiety and sleep disorders, puts treating physicians on track. In case of suspicion of PTSD, a referral to a specialist can confirm the diagnosis, so that a specific trauma therapy can be initiated. While Crohn’s disease is incurable, PTSD isn’t.

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1 comment:

Mrs Augustina Ogbodo
Mrs Augustina Ogbodo

This is an interesting article because i never considered patients with physical illnesses to be prone to PTSD.

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