title: Aspects of posttraumatic stress disorder in long-term testicular cancer survivors: cross-sectional and longitudinal findings.
abstract: The purpose of this research is to study the prevalence of posttraumatic stress disorder (PTSD) and variables associated with PTSD in Norwegian long-term testicular cancer survivors (TCSs) both cross-sectionally and longitudinally.
  
  
  
  At a mean of 11 years after diagnosis, 1418 TCSs responded to a mailed questionnaire, and at a mean of 19 years after diagnosis, 1046 of them responded again to a modified questionnaire. Posttraumatic symptoms related to testicular cancer were self-rated with the Impact of Event Scale (IES) at the 11-year study only. An IES total score ≥35 defined Full PTSD, and a score 26-34 identified Partial PTSD, and the combination of Full and Partial PTSD defined Probable PTSD.
  
  
  
  At the 11-year study, 4.5 % had Full PTSD, 6.4 % had Partial PTSD, and 10.9 % Probable had PTSD. At both studies, socio-demographic variables, somatic health, anxiety/depression, chronic fatigue, and neurotoxic adverse effects were significantly associated with Probable PTSD in bivariate analyses. Probable anxiety disorder, poor self-rated health, and neurotoxicity remained significant with Probable PTSD in multivariate analyses at the 11-year study. In bivariate analyses, probable PTSD at that time significantly predicted socio-demographic variables, somatic health, anxiety/depression, chronic fatigue, and neurotoxicity among participants of the 19-year study, but only probable anxiety disorder remained significant in multivariable analysis.
  
  
  
  In spite of excellent prognosis, 10.9 % of long-term testicular cancer survivors had Probable PTSD at a mean of 11 years after diagnosis. Probable PTSD was significantly associated with a broad range of problems both at that time and was predictive of considerable problems at a mean of 19 year postdiagnosis.
  
  
  
  Among long-term testicular cancer survivors, 10.9 % have Probable PTSD with many associated problems, and therefore health personnel should explore stress symptoms at follow-up since efficient treatments are available.
authors.affiliation: National Advisory Unit for Long-Term Adverse Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, P.O. Box 4953, Nydalen, N-0424, Oslo, Norway. a.a.dahl@ibv.uio.no.|University of Oslo, Oslo, Norway. a.a.dahl@ibv.uio.no.
authors.forename: Alv A
authors.initials: AA
authors.lastname: Dahl
authors.affiliation: Faculty of Medicine, University of Southern Denmark, Odense, Denmark.
authors.forename: Marie
authors.initials: M
authors.lastname: Østby-Deglum
authors.affiliation: Department of Oncology, Akershus University Hospital, Lørenskog, Norway.
authors.forename: Jan
authors.initials: J
authors.lastname: Oldenburg
authors.affiliation: Department of Oncology, University Hospital of Northern Norway, University of Northern Norway, Tromsø, Norway.
authors.forename: Roy
authors.initials: R
authors.lastname: Bremnes
authors.affiliation: Department of Oncology, Haukeland University Hospital, University of Bergen, Bergen, Norway.
authors.forename: Olav
authors.initials: O
authors.lastname: Dahl
authors.affiliation: Department of Oncology, Saint Olav's Hospital, National University for Science and Technology, Trondheim, Norway.
authors.forename: Olbjørn
authors.initials: O
authors.lastname: Klepp
authors.affiliation: University of Oslo, Oslo, Norway.|Department of Oncology, Oslo University Hospital, Ullevål Hospital, Oslo, Norway.
authors.forename: Erik
authors.initials: E
authors.lastname: Wist
authors.affiliation: National Advisory Unit for Long-Term Adverse Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, P.O. Box 4953, Nydalen, N-0424, Oslo, Norway.|University of Oslo, Oslo, Norway.
authors.forename: Sophie D
authors.initials: SD
authors.lastname: Fosså
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D015995:Prevalence; D011379:Prognosis; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D013736:Testicular Neoplasms / Q000150:complications / Q000523:psychology* / Q000628:therapy
keywords: Impact of Event Scale; Long-term study; Posttraumatic stress disorder; Prevalence; Testicular cancer