Aspects of posttraumatic stress disorder in long-term testicular cancer survivors: cross-sectional and longitudinal findings

Alv A Dahl; Marie Østby-Deglum; Jan Oldenburg; Roy Bremnes; Olav Dahl; Olbjørn Klepp; Erik Wist; Sophie D Fosså

doi:10.1007/s11764-016-0529-4

Aspects of posttraumatic stress disorder in long-term testicular cancer survivors: cross-sectional and longitudinal findings

J Cancer Surviv. 2016 Oct;10(5):842-9. doi: 10.1007/s11764-016-0529-4. Epub 2016 Feb 26.

Authors

Alv A Dahl^{1

2}, Marie Østby-Deglum³, Jan Oldenburg⁴, Roy Bremnes⁵, Olav Dahl⁶, Olbjørn Klepp⁷, Erik Wist^{8

9}, Sophie D Fosså^{10

8}

Affiliations

¹ National Advisory Unit for Long-Term Adverse Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, P.O. Box 4953, Nydalen, N-0424, Oslo, Norway. a.a.dahl@ibv.uio.no.
² University of Oslo, Oslo, Norway. a.a.dahl@ibv.uio.no.
³ Faculty of Medicine, University of Southern Denmark, Odense, Denmark.
⁴ Department of Oncology, Akershus University Hospital, Lørenskog, Norway.
⁵ Department of Oncology, University Hospital of Northern Norway, University of Northern Norway, Tromsø, Norway.
⁶ Department of Oncology, Haukeland University Hospital, University of Bergen, Bergen, Norway.
⁷ Department of Oncology, Saint Olav's Hospital, National University for Science and Technology, Trondheim, Norway.
⁸ University of Oslo, Oslo, Norway.
⁹ Department of Oncology, Oslo University Hospital, Ullevål Hospital, Oslo, Norway.
¹⁰ National Advisory Unit for Long-Term Adverse Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, P.O. Box 4953, Nydalen, N-0424, Oslo, Norway.

PMID: 26920871
DOI: 10.1007/s11764-016-0529-4

Abstract

Purpose: The purpose of this research is to study the prevalence of posttraumatic stress disorder (PTSD) and variables associated with PTSD in Norwegian long-term testicular cancer survivors (TCSs) both cross-sectionally and longitudinally.

Methods: At a mean of 11 years after diagnosis, 1418 TCSs responded to a mailed questionnaire, and at a mean of 19 years after diagnosis, 1046 of them responded again to a modified questionnaire. Posttraumatic symptoms related to testicular cancer were self-rated with the Impact of Event Scale (IES) at the 11-year study only. An IES total score ≥35 defined Full PTSD, and a score 26-34 identified Partial PTSD, and the combination of Full and Partial PTSD defined Probable PTSD.

Results: At the 11-year study, 4.5 % had Full PTSD, 6.4 % had Partial PTSD, and 10.9 % Probable had PTSD. At both studies, socio-demographic variables, somatic health, anxiety/depression, chronic fatigue, and neurotoxic adverse effects were significantly associated with Probable PTSD in bivariate analyses. Probable anxiety disorder, poor self-rated health, and neurotoxicity remained significant with Probable PTSD in multivariate analyses at the 11-year study. In bivariate analyses, probable PTSD at that time significantly predicted socio-demographic variables, somatic health, anxiety/depression, chronic fatigue, and neurotoxicity among participants of the 19-year study, but only probable anxiety disorder remained significant in multivariable analysis.

Conclusions: In spite of excellent prognosis, 10.9 % of long-term testicular cancer survivors had Probable PTSD at a mean of 11 years after diagnosis. Probable PTSD was significantly associated with a broad range of problems both at that time and was predictive of considerable problems at a mean of 19 year postdiagnosis.

Implications for cancer survivors: Among long-term testicular cancer survivors, 10.9 % have Probable PTSD with many associated problems, and therefore health personnel should explore stress symptoms at follow-up since efficient treatments are available.

Keywords: Impact of Event Scale; Long-term study; Posttraumatic stress disorder; Prevalence; Testicular cancer.

MeSH terms

Adult
Cross-Sectional Studies
Female
Humans
Longitudinal Studies
Male
Middle Aged
Norway / epidemiology
Prevalence
Prognosis
Stress Disorders, Post-Traumatic / diagnosis
Stress Disorders, Post-Traumatic / epidemiology
Stress Disorders, Post-Traumatic / etiology*
Surveys and Questionnaires
Survivors / psychology*
Testicular Neoplasms / complications
Testicular Neoplasms / psychology*
Testicular Neoplasms / therapy