1. Quality of life and mood predict posttraumatic stress disorder after hematopoietic stem cell transplantation.
- Author
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El-Jawahri AR, Vandusen HB, Traeger LN, Fishbein JN, Keenan T, Gallagher ER, Greer JA, Pirl WF, Jackson VA, Spitzer TR, Chen YB, and Temel JS
- Subjects
- Adult, Aged, Female, Hematologic Neoplasms therapy, Hospitalization, Humans, Leukemia psychology, Leukemia therapy, Longitudinal Studies, Lymphoma psychology, Lymphoma therapy, Male, Middle Aged, Multiple Myeloma psychology, Multiple Myeloma therapy, Myelodysplastic Syndromes psychology, Myelodysplastic Syndromes therapy, Primary Myelofibrosis psychology, Primary Myelofibrosis therapy, Prospective Studies, Transplantation, Autologous, Transplantation, Homologous, Affect, Anxiety psychology, Depression psychology, Hematologic Neoplasms psychology, Hematopoietic Stem Cell Transplantation psychology, Quality of Life psychology, Stress Disorders, Post-Traumatic psychology
- Abstract
Background: During hospitalization for hematopoietic stem cell transplantation (HCT), patients experience a steep deterioration in quality of life (QOL) and mood. To our knowledge, the impact of this deterioration on patients' QOL and posttraumatic stress disorder (PTSD) symptoms after HCT is unknown., Methods: We conducted a prospective longitudinal study of patients hospitalized for HCT. They assessed QOL using the Functional Assessment of Cancer Therapy-Bone Marrow Transplantation (FACT-BMT) and depression and anxiety symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9) at the time of admission for HCT, during hospitalization, and 6 months after HCT. We also used the Hospital Anxiety and Depression Scale (HADS) to measure patients' anxiety and depression symptoms at baseline and during HCT hospitalization. The PTSD Checklist was used to assess for PTSD symptoms. Multivariable linear regression models were used to identify predictors of QOL and PTSD symptoms at 6 months., Results: We enrolled 90 of 93 consecutively eligible patients (97%) undergoing autologous and allogeneic HCT. Data at 6 months were available for 67 participants. At 6 months, 28.4% of participants met the criteria for PTSD and 43.3% had clinically significant depression. On multivariable regression analyses adjusting for significant covariates, changes in QOL and depression scores from week 2 of HCT hospitalization to baseline predicted worse QOL (changes in scores between week 2 and baseline [Δ] QOL: β, 0.94 [P<.0001] and Δ PHQ-9: β, -2.59 [P = 0.001]) and PTSD symptoms (Δ QOL: β, -0.40 [P<.0001] and Δ PHQ-9: β, 1.26 [P<.0001]) at 6 months after HCT., Conclusions: Six months after HCT, a significant percentage of patients met the criteria for PTSD and depression. A decline in QOL and an increase in depressive symptoms during hospitalization for HCT were found to be the most important predictors of 6-month QOL impairment and PTSD symptoms. Therefore, managing symptoms of depression and QOL deterioration during HCT hospitalization may be critical to improving QOL at 6 months and reducing the risk of PTSD. Cancer 2016;122:806-812. © 2015 American Cancer Society., (© 2015 American Cancer Society.)
- Published
- 2016
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