Post-traumatic stress disorder (PTSD) in cardiology and oncology--which diagnostic tools should be used?

J Psychosom Res. 2012 Jun;72(6):434-8. doi: 10.1016/j.jpsychores.2012.02.008. Epub 2012 Mar 28.

Abstract

Objectives: PTSD prevalence rates in cardiac and cancer patients greatly vary probably due to diverging samples, designs and assessments. Aim of this study was therefore to compare prevalence rates of PTSD as well as instruments assessing PTSD in different cardiac and cancer patient groups.

Methods: A total of 274 cardiac and cancer patients were examined with the Post-Traumatic Stress Scale 10 (PTSS-10) and the Impact of Event Scale - revised (IES-R). Presence of PTSD was validated by Structured Clinical Interview for DSM-IV (SCID).

Results: Diagnostic criteria for the existence of PTSD were met by 29.2% of all patients via PTSS-10, by 7.6% in IES-R and by 4.8% in SCID, indicating substantial discrepancy among assessments. This is further underlined by the moderate correlation between self-reports and poor agreement with the standardised interview.

Conclusion: A structured interview is the "gold standard" for diagnosing PTSD in cardiac and cancer patients. Questionnaires can be used as screening instruments when they reliably assess trauma-related diagnostic criteria. Further studies are necessary to clarify the specifics of trauma criteria in medical setting.

MeSH terms

  • Aged
  • Arrhythmias, Cardiac / psychology
  • Coronary Disease / psychology
  • Female
  • Heart Diseases / psychology*
  • Heart-Lung Transplantation / psychology
  • Humans
  • Interview, Psychological
  • Male
  • Marital Status
  • Middle Aged
  • Neoplasms / psychology*
  • Prevalence
  • Psychiatric Status Rating Scales
  • Stem Cell Transplantation / psychology
  • Stress Disorders, Post-Traumatic / diagnosis
  • Stress Disorders, Post-Traumatic / epidemiology*
  • Stress Disorders, Post-Traumatic / psychology