title: Acute stress in patients with brain cancer during primary care.
abstract: OBJECTIVE
  This study investigated whether diagnosis and neurosurgical removal of a brain tumour induced Acute Stress Disorder (ASD) in adults. We also aimed to identify factors associated with the development of ASD in this specific patient group and setting.
  
  
  METHODS
  Forty-seven consecutive patients with intracranial neoplasms completed a variety of self-report questionnaires and underwent a structured clinical interview (SCID) within the first 4 weeks after tumour detection on average 1 week after neurosurgical treatment. Moreover, the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), A1 and A2 criterion and thus the characteristics of the traumatic event were explored in detail.
  
  
  RESULTS
  ASD symptoms were common. Twenty-three percent of the patients met stringent criteria of ASD and another 4% suffered from subsyndromal ASD. Predisposing factors previously reported in literature with the exception of previous trauma could not be identified in this study (e.g., sex, age, intelligence).
  
  
  CONCLUSIONS
  It has been critically discussed whether the diagnosis of ASD is appropriate in cancer patients due to the often future-related nature of cancer-related traumatic events. The diagnosis of ASD was justified in the vast majority of affected patients due to the specific, acute and past traumatic experiences in concordance with the DSM and International Statistical Classification of Diseases and Related Health Problems (ICD) trauma definitions. Thus, ASD is a common and relevant psychiatric comorbidity in patients with brain tumours. Our data highlight both the need for the routine psychological assessment as well as of psychosocial support in this early treatment phase.
authors: Department of Neurosurgery, University Hospital Schleswig-Holstein, Arnold-Heller-Str 3, 24105 Kiel, Germany. goebels@nch.uni-kiel.de
authors: Simone
authors: S
authors: Goebel
authors: Hans
authors: H
authors: Strenge
authors: H Maximilian
authors: HM
authors: Mehdorn
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000523:psychology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D011446:Prospective Studies; D012307:Risk Factors; D040701:Stress Disorders, Traumatic, Acute / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D011795:Surveys and Questionnaires; D055815:Young Adult