title: Clinically assessed posttraumatic stress in patients with breast cancer during the first year after diagnosis in the prospective, longitudinal, controlled COGNICARES study.
abstract: There is ongoing debate whether cancer qualifies as traumatic stressor. We investigated prevalence and course of posttraumatic stress in patients with early breast cancer (BC) during their first year after diagnosis and determined effects of mastectomy and chemotherapy.
  
  
  
  Patients with stage 0-III BC aged ≤65 years were evaluated with the Structured Clinical Interview for DSM-IV modules for acute and posttraumatic stress disorder (ASD and PTSD, respectively) before treatment, after chemotherapy, and 1 year after diagnosis. Matched controls were assessed at matched intervals. Effects of time, mastectomy, and chemotherapy on BC-related PTSD symptom severity were tested with linear mixed model analysis.
  
  
  
  Stress disorder (ASD or PTSD) related to BC was diagnosed in 6 (3.6%) of 166 patients before treatment and in 3 patients (2.0%) 1 year later. The rate of patients who experienced PTSD symptoms related to BC decreased from 82.5 to 57.3% (p < 0.001), and the mean of BC-related PTSD symptoms diminished from 3.1 to 1.7 (p < 0.001). Only university education significantly predicted the course of BC-related PTSD symptom severity (p = 0.009). In 60 controls, no diagnosis of stress disorder, a rate of 18% women experiencing PTSD symptoms, and a mean of 0.4 PTSD symptoms (p vs. patients <0.001) were found.
  
  
  
  Most newly diagnosed patients with BC experience PTSD symptoms, whereas full diagnoses of DSM-IV stress disorder are rare. Symptoms diminish somewhat within 1 year furthered by university education but independently from mastectomy and chemotherapy. Throughout the year after diagnosis, having BC entails markedly increased PTSD symptom burden. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Breast Center, Department of Gynecology and Obstetrics, CCCLMU University Hospital of Munich, Munich, Germany.
authors.forename: Varinka
authors.initials: V
authors.lastname: Voigt
authors.affiliation: Breast Center, Department of Gynecology and Obstetrics, CCCLMU University Hospital of Munich, Munich, Germany.
authors.forename: Franziska
authors.initials: F
authors.lastname: Neufeld
authors.affiliation: Breast Center, Department of Gynecology and Obstetrics, CCCLMU University Hospital of Munich, Munich, Germany.
authors.forename: Judith
authors.initials: J
authors.lastname: Kaste
authors.affiliation: Department of Psychology, Division of Psychological Methods and Assessment, Ludwig Maximilian University of Munich, Munich, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Bühner
authors.affiliation: Department of Psychology, Division of Psychological Methods and Assessment, Ludwig Maximilian University of Munich, Munich, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Sckopke
authors.affiliation: Breast Center, Department of Gynecology and Obstetrics, CCCLMU University Hospital of Munich, Munich, Germany.
authors.forename: Rachel
authors.initials: R
authors.lastname: Wuerstlein
authors.affiliation: Institute for Clinical Radiology, CCCLMU University Hospital of Munich, Munich, Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Hellerhoff
authors.affiliation: Institute for Clinical Radiology, CCCLMU University Hospital of Munich, Munich, Germany.
authors.forename: Anikó
authors.initials: A
authors.lastname: Sztrókay-Gaul
authors.affiliation: Breast Center, Department of Gynecology, Red Cross Hospital, Munich, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Braun
authors.affiliation: Breast Center, Department of Gynecology and Obstetrics, Dritter Orden Hospital, Munich, Germany.
authors.forename: Franz Edler
authors.initials: FE
authors.lastname: von Koch
authors.affiliation: Breast Center, Department of Gynecology and Obstetrics, CCCLMU University Hospital of Munich, Munich, Germany.
authors.forename: Eliane
authors.initials: E
authors.lastname: Silva-Zürcher
authors.affiliation: Breast Center, Department of Gynecology and Obstetrics, CCCLMU University Hospital of Munich, Munich, Germany.|Breast Center, Department of Gynecology and Obstetrics, District Hospital of Ebersberg, Ebersberg, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Hasmüller
authors.affiliation: Breast Center, Department of Gynecology and Obstetrics, Hospital of Landshut, Landshut, Germany.
authors.forename: Ingo
authors.initials: I
authors.lastname: Bauerfeind
authors.affiliation: Breast Center, Department of Gynecology and Obstetrics, Helios Amper Hospital Dachau, Dachau, Germany.
authors.forename: Gerlinde
authors.initials: G
authors.lastname: Debus
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Division of Psychosocial Oncology, Roman Herzog Comprehensive Cancer Center, Technical University of Munich, Munich, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Herschbach
authors.affiliation: Breast Center, Department of Gynecology and Obstetrics, CCCLMU University Hospital of Munich, Munich, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Mahner
authors.affiliation: Breast Center, Department of Gynecology and Obstetrics, CCCLMU University Hospital of Munich, Munich, Germany.
authors.forename: Nadia
authors.initials: N
authors.lastname: Harbeck
authors.affiliation: Breast Center, Department of Gynecology and Obstetrics, CCCLMU University Hospital of Munich, Munich, Germany.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Hermelink
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000523:psychology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000523:psychology*
keywords: acute stress disorder; breast cancer; cancer; oncology; posttraumatic stress disorder