Posttraumatic stress disorder symptomatology in the course of allogeneic HSCT: a prospective study.

Abstract

Despite the life-threatening character of allogeneic hematopoietic stem cell transplantation (allogeneic HSCT), very few longitudinal research exists on posttraumatic stress disorder (PTSD) symptomatology in this patient group. We investigated prevalence, temporal course and predictors of PTSD symptomatology in this population. Patients were assessed before conditioning (T0), 100days (T1), and 12months after HSCT (T2). PTSD symptomatology was measured with the PTSD Checklist-Civilian Version. We conducted multilevel modeling and multiple regression analyses. Two hundred thirty-nine patients participated at baseline, 150 at T1, and 102 at T2. Up to 15% met the criteria for PTSD at least once during the course of assessment. Fifty-two percent showed diagnostic relevant levels of intrusion, 30% of avoidance, and 33% of arousal at least once. Apart from arousal, which increased between T0 and T1 (γ=0.56, p=0.03), no other severity score significantly differed between time points. Being impaired by pain (γ=2.89, p<0.01), pain level (γ=0.63, p=0.02), and being female (γ=3.81, p<0.01) emerged as significant predictors of PTSD symptomatology when taking into account all time points. Acute plus chronic graft-versus-host-disease and longer hospital stay predicted PTSD symptomatology at T2 (γ=3.39, p=0.04; γ=0.1, p=0.03). A considerable number of patients undergoing allogeneic HSCT met the criteria for PTSD. PTSD symptomatology is prominent at all assessment points. Burden of pain, being female, and medical complications are risk factors for elevated levels of PTSD symptomatology. Psychological support should be offered not only after treatment but also in the long-term and even before HSCT. Professionals should be aware of the psychological consequences accompanied by pain and complications.