The Relationship Between Posttraumatic Stress Disorder, Mood States, Functional Status, and Quality of Life in Oncology Outpatients

Context. Oncology patients are at risk for developing posttraumatic stress disorder (PTSD) and other comorbid mood states, which are associated with decreases in functional status and quality of life (QOL). However, few studies have investigated the relationship between PTSD, other mood states, functional status, and QOL in oncology outpatients. Objectives. This study had four aims: 1) determine the percentages of patients with PTSD and partial PTSD; 2) evaluate for differences in demographic and clinical characteristics among patients with PTSD, partial PTSD, and no PTSD; 3) evaluate for differences in mood states, functional status, and QOL among the three PTSD groups; and 4) evaluate whether demographic and disease characteristics were predictors of PTSD. Methods. As part of a larger clinical trial that evaluated the effects of a cognitive-behavioral intervention on cancer pain management, 289 adult oncology patients (M-age = 61.3, SD = 11.6) completed self-report measures that assessed PTSD, other mood states, functional status, and QOL. Results. Forty-five percent of the sample met the diagnostic criteria for PTSD (n = 78) and partial PTSD (n = 53) and were younger than those with no PTSD. Patients with PTSD had a significantly lower Karnofsky Performance Status, shorter time since diagnosis, higher ratings of mood disturbance, lower ratings of functional status, and lower QOL than patients with no PTSD. A lower Karnofsky Performance Status, fewer months since diagnosis, and presence of bone metastases predicted a higher likelihood of being classified as having PTSD. Conclusion. Early identification and interventions may mediate the onset of psychological distress and improve health outcomes. J Pain Symptom Manage 2012;44:520-531. (C) 2012 U. S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.