Thursday, May 22, 2008

Parents of Children with Cancer Commonly Have PTSD Symptoms

Copy of the article:

NEW YORK NOV 11, 2005 (Reuters Health) - Most parents of children undergoing cancer treatment report posttraumatic stress disorder (PTSD) symptoms, according to a report in the October 20th Journal of Clinical Oncology.

Symptoms of PTSD have been reported in parents of children who have completed treatment for cancer, the authors explain, but it remains unclear when PTSD symptoms arise during the course of treatment.

Dr. Anne E. Kazak and colleagues from Children's Hospital of Philadelphia and University of Pennsylvania used the Posttraumatic Stress Disorder Reaction Index (PTSD-RI) and the Impact of Event Scale-Revised (IES-R) to evaluate PTSD symptoms in 119 mothers and 52 fathers of 171 children in current treatment for a pediatric malignancy. Overall participant rate was 78.6%.

The mean PTSD-RI scores for mothers and fathers were within the range of moderate PTSD, the authors report. All but one parent reported symptoms consistent with at least mild PTSD.

More than two thirds of the mothers and 57% of the fathers had PTSD within the moderate-to-severe range, the results indicate. In families in which both parents participated in the survey, 79.2% had at least one parent with moderate-to-severe PTSD.

Only rarely did both parents report severe symptoms, and it was uncommon for both parents to report mild PTSD.

Treatment intensity was not associated with distress level for mothers or fathers, the researchers note, but there was a low-magnitude negative association between the length of time since their child's diagnosis and the level of PTSD.

"These data raise complex issues regarding the meaning of elevated PTSD symptoms during treatment," the investigators write. "Given the high rate of prevalence of PTSD symptoms, for example, it would be inappropriate to assume that PTSD symptoms indicate psychiatric impairment. They are, for many, part of the process of responding and reacting to one's circumstances and may be adaptive in certain ways."

"Knowledge and attention to PTSD symptoms can lead to more appropriate multidisciplinary care of the patient and family," the authors conclude.

"Early identification of at-risk families may promote the development and evaluation of effective brief treatments. By helping caregivers address their own psychological well-being, we may be best assuring that the psychological needs of the patients are also met."

"Brief and efficacious treatments have been developed to assist parents in adjusting to their child's diagnosis and treatment, and effective psychological treatments for posttraumatic disorders have been developed," writes Dr. Sharon Manne from Fox Chase Cancer Center, Philadelphia, in a related editorial.

"Traditional evaluations of parent distress should be broadened to include assessment of traumatic stress responses, and parents should be screened routinely and offered evidence-based psychosocial care when they experience severe levels of traumatic stress symptomatology," Dr. Manne concludes.

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