title: Traumatic stress in acute leukemia.
abstract: OBJECTIVE
  Acute leukemia is a condition with an acute onset that is associated with considerable morbidity and mortality. However, the psychological impact of this life-threatening condition and its intensive treatment has not been systematically examined. In the present study, we investigate the prevalence and correlates of post-traumatic stress symptoms in this population.
  
  
  METHODS
  Patients with acute myeloid, lymphocytic, and promyelocytic leukemia who were newly diagnosed, recently relapsed, or treatment failures were recruited at a comprehensive cancer center in Toronto, Canada. Participants completed the Stanford Acute Stress Reaction Questionnaire, Memorial Symptom Assessment Scale, CARES Medical Interaction Subscale, and other psychosocial measures. A multivariate regression analysis was used to assess independent predictors of post-traumatic stress symptoms.
  
  
  RESULTS
  Of the 205 participants, 58% were male, mean age was 50.1 ± 15.4 years, 86% were recently diagnosed, and 94% were receiving active treatment. The mean Stanford Acute Stress Reaction Questionnaire score was 30.2 ± 22.5, with 27 of 200 (14%) patients meeting criteria for acute stress disorder and 36 (18%) for subsyndromal acute stress disorder. Post-traumatic stress symptoms were associated with more physical symptoms, physical symptom distress, attachment anxiety, and perceived difficulty communicating with health-care providers, and poorer spiritual well-being (all p < 0.05).
  
  
  CONCLUSIONS
  The present study demonstrates that clinically significant symptoms of traumatic stress are common in acute leukemia and are linked to the degree of physical suffering, to satisfaction with relationships with health-care providers, and with individual psychological characteristics. Longitudinal study is needed to determine the natural history, but these findings suggest that intervention may be indicated to alleviate or prevent traumatic stress in this population.
authors.affiliation: Department of Psychosocial Oncology and Palliative Care, Princess Margaret Hospital, University Health Network, Toronto, Canada. gary.rodin@uhn.ca
authors.forename: Gary
authors.initials: G
authors.lastname: Rodin
authors.forename: Dora
authors.initials: D
authors.lastname: Yuen
authors.forename: Ashley
authors.initials: A
authors.lastname: Mischitelle
authors.forename: Mark D
authors.initials: MD
authors.lastname: Minden
authors.forename: Joseph
authors.initials: J
authors.lastname: Brandwein
authors.forename: Aaron
authors.initials: A
authors.lastname: Schimmer
authors.forename: Charles
authors.initials: C
authors.lastname: Marmar
authors.forename: Lucia
authors.initials: L
authors.lastname: Gagliese
authors.forename: Christopher
authors.initials: C
authors.lastname: Lo
authors.forename: Anne
authors.initials: A
authors.lastname: Rydall
authors.forename: Camilla
authors.initials: C
authors.lastname: Zimmermann
mesh_terms: D000328:Adult; D000368:Aged; D002170:Canada; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000523:psychology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000523:psychology*; D011369:Professional-Patient Relations; D012044:Regression Analysis; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*; D011795:Surveys and Questionnaires
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