title: Cancer-and-treatment-specific distress and its impact on posttraumatic stress in patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT).
abstract: In this prospective multicenter study, we investigated cancer-and-treatment-specific distress (CTXD) and its impact on symptoms of posttraumatic stress disorder (PTSD) in patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT).
  
  
  
  Patients were consulted before (T0, N = 239), 3 (T1, N = 150), and 12 months (T2, N = 102) after HSCT. Medical (eg, diagnosis and pretreatment) and demographic information, CTXD and PTSD (PCL-C) were assessed.
  
  
  
  Random intercept models revealed that the sum score of CTXD was highest pre-HSCT (T0), decreased by T1 (γ = -.18, 95% CI [-.26/-.09]), and by T2 (γ = -.10, 95% CI [-.20/-.00]). Uncertainty, family strain, and health burden were rated most distressing during HSCT. Uncertainty and family strain decreased from T0 to T1 (γ = -.30, 95% CI [-.42/-.17]; γ = -.10, 95% CI [-.20/-.00]) and health burden from T1 to T2 (γ = -.21, 95% CI [-.36/.05]). Women were more likely to report uncertainty (γ = .38, 95% CI [.19/.58]), family strain (γ = .38, 95% CI [.19/.58]), and concerns regarding appearance and sexuality (γ = .31, 95% CI [.14/.47]) than men. Uncertainty (γ = .18, 95% CI [.12/.24]), appearance and sexuality (γ = .09, 95% CI [.01/.16]), and health burden (γ = .21, 95% CI [.14/.27]) emerged as predictors of PTSD symptomatology across the 3 assessment points.
  
  
  
  Our data provide first evidence regarding the course of 6 dimensions of CTXD during HSCT and their impact on PTSD symptomatology. Specifically, results emphasize the major burden of uncertainty pre-HSCT and the impact of uncertainty and concerns regarding appearance and sexuality on PTSD symptomatology.
authors.affiliation: Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany.
authors.forename: Katharina
authors.identifier: 0000-0002-7551-7931
authors.initials: K
authors.lastname: Kuba
authors.affiliation: Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Esser
authors.affiliation: Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Angela
authors.initials: A
authors.lastname: Scherwath
authors.affiliation: Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Lena
authors.initials: L
authors.lastname: Schirmer
authors.affiliation: Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Schulz-Kindermann
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University Munich, Munich, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Dinkel
authors.affiliation: Department of Medical Psychology and Medical Sociology, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany.
authors.forename: Friedrich
authors.initials: F
authors.lastname: Balck
authors.affiliation: Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Koch
authors.affiliation: Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Nicolaus
authors.initials: N
authors.lastname: Kröger
authors.affiliation: Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany.
authors.forename: Heide
authors.initials: H
authors.lastname: Götze
authors.affiliation: Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany.|Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Mehnert
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005858:Germany; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy*; D011446:Prospective Studies; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000209:etiology; D011795:Surveys and Questionnaires; D014184:Transplantation, Homologous
keywords: cancer; cancer-and-treatment-specific distress; hematopoietic stem cell transplantation; oncology; posttraumatic stress symptoms