Posttraumatic stress disorder and preparatory grief in advanced cancer

Purpose: The purpose of the current study was to investigate the prevalence of posttraumatic stress disorder (PTSD) and its association with sociodemographic variables and preparatory grief in patients with advanced cancer. Methods: 195 advanced cancer patients participated in the study. Out of them, 170 had PTSD and 25 had other anxiety disorders. The diagnoses were made in strict accordance with Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I)-Clinician version. Patients completed also the Preparatory Grief in Advanced Cancer Patients (PGAC) scale. Results: Patients with PTSD were younger (63.54+/- 12.07 years) than those without PTSD (70.36+/-13.03 years, p=0.010). Patients with PTSD revealed more preparatory grief (37.69+/-12.11) than those without PTSD (29.58+/-14.04, p=0.003). Multiple logistic regression analysis showed that preparatory grief (p=0.012), and metastatic disease (p=0.009) remained in the model whereas age showed a trend for independent significance (p=0.067). Conclusion: In advanced cancer stages, younger patients, those with metastatic disease or patients with elevated scores on preparatory grief seemed to have a greater likelihood to develop PTSD. Thus, given the prevalence of PTSD in advanced cancer patients, health care professionals should be able to better recognize those who are at risk for or exhibit symptoms of this disorder so that appropriate treatment referrals can be made.