[show abstract][hide abstract] ABSTRACT: A significant number of survivors of hematopoietic stem-cell transplantation (HSCT) report enduring adverse effects of treatment, including illness-related post-traumatic stress disorder (PTSD) symptoms and general distress. We report results of a randomized clinical trial that tested the effects of a 10-session, telephone-administered cognitive-behavioral therapy (CBT) intervention on PTSD, depression, and distress symptoms.
Survivors who had undergone HSCT 1 to 3 years earlier (N = 408) were assessed for study eligibility. Those who met study eligibility criteria (n = 89) completed a baseline assessment that included a clinical interview and self-report measures of PTSD symptoms (the primary outcome) and depression and general distress (the secondary outcomes). Next, they were randomly assigned to CBT or an assessment-only condition. Survivors in the CBT group completed 10 individual telephone-based CBT sessions (T-CBT) that included strategies to reduce PTSD symptoms, depression, and general distress. Follow-up assessments occurred at 6, 9, and 12 months after the baseline assessment.
Linear mixed-model analyses revealed that, compared with HSCT survivors in the assessment-only condition, survivors who completed T-CBT reported fewer illness-related PTSD symptoms, including less avoidance (P < .001) and fewer intrusive thoughts (P < .05) as well as less general distress and fewer depressive symptoms (P < .05) even after controlling for potential demographic and medical covariates. These results were consistent across the three follow-up assessments.
A brief, telephone-administered CBT intervention developed for HSCT survivors is an efficacious treatment for reducing illness-related PTSD symptoms and general distress.
Journal of Clinical Oncology 08/2010; 28(23):3754-61. · 18.04 Impact Factor
[show abstract][hide abstract] ABSTRACT: The prevalence of psychological distress is higher in cancers with poorer prognoses and speculated as higher in those receiving more aversive treatments. Since hematopoietic stem cell transplant (HSCT) is one of the most taxing cancer treatments to endure and is therefore likely to have more long-term sequelae, this study examined psychological distress symptoms in long-term HSCT survivors who were at least 1 year post-transplant. Participants in this cross-sectional study were recruited from urban medical centers as part of a larger study of HSCT survivors. The sample comprised 236 adults who were on average 3.4 years since transplant. Psychological distress was measured by a commonly used self-report questionnaire, the Brief Symptom Inventory. Clinically elevated psychological distress caseness was present in 43% of long-term HSCT survivors. Elevations were highest on clinical subscales of obsessive-compulsiveness, somatization, and psychoticism. However, item-level analyses revealed that the content of the most frequently reported symptoms included trouble with memory and feelings of loneliness. Results of this study suggest that HSCT survivors may experience memory and existential concerns and that such symptoms may not represent psychiatric sequelae.
[show abstract][hide abstract] ABSTRACT: There is an emerging consensus that between one fifth and one half of breast cancer patients experience chemotherapy-associated cognitive dysfunction. Research shows that patients with cancer are often interested in acupuncture for symptom relief. A clinical question thus arises: What should physicians advise their patients regarding the use of acupuncture to alleviate or ameliorate chemotherapy-associated cognitive dysfunction? The authors review and synthesize 2 bodies of relevant research literature: (1) the developing literature on the etiology and nature of chemotherapy-associated cognitive dysfunction and (2) the literature concerning acupuncture for neurological diseases and psychological issues. There is evidence that acupuncture may be effectively used to manage a range of psychoneurological issues, some of which are similar to those experienced by patients with chemotherapy-associated cognitive dysfunction. The evidence of efficacy is more promising for psychological than neurological conditions. Given evidence of possible efficacy combined with evidence of demonstrated safety, we suggest that physicians should support patient decisions to use acupuncture services for chemotherapy-associated cognitive dysfunction, especially given the lack of proven alternatives.
Integrative Cancer Therapies 04/2007; 6(1):36-41. · 2.35 Impact Factor