2024 Science of Caring Grand Rounds | Post Traumatic Stress Disorder in Cancer Patients: Conceptual Overview and Clinical Treatment
Current understanding and research of emotional distress in the cancer setting is based on seminal studies in the 1970's and early 1980's when Post Traumatic Stress Disorder (PTSD) was not an official psychiatric diagnosis and or just recently officially recognized, but poorly understood. Current studies continue to use survey instruments, which were developed before PTSD was a recognized diagnosis and thus, continue to underappreciate the prevalence of PTSD and Acute Stress Disorder symptoms. For example, the Hospital Anxiety and Depression Scale is a commonly used instrument, which does not speak to Post Traumatic Stress Disorder.
This educational gap's persistence is partly due to diagnostic and research disagreement over the diagnosis of PTSD. Some researchers argue for a criteria favoring acute, discreet traumatic experience such as injury in military combat or sexual assault, and discount more diffuse traumas such as the cancer experience, incarceration in a concentration camp, or a protracted genocide experience because of difficulty in identifying the discrete traumatic incident. However, from the patient perspective, this is likely a misguided impediment to care and would represent an additional trauma if they were confronted with this type of invalidation of their suffering.
Research suggests that previously traumatized patients are 14 fold more likely to develop PTSD from their cancer experience than patients without previous PTSD. Traumatized patients have elevated risk of treatment avoidance, viewing authority figures as non-helpful, and are more likely to be distressed by their cancer experience. This has implications for resource utilization and clinical outcomes. PTSD was found to be the psychiatric symptom cluster with the most detrimental influence on healthcare related quality of life. Detection and early intervention could have a significant effect on resource utilization, clinical outcomes, and emotional burden to treating staff. It is, therefore, imperative to have greater awareness of and sensitivity to potential PTSD symptoms in order to be better equipped to treat selected patients.
All health care providers of the multidisciplinary team.
- Analyze basic neurobiology and teleology of Post Traumatic Stress Disorder (PTSD).
- Identify symptoms of PTSD.
- Distinguish core symptoms of PTSD from core symptoms of Major Depressive Disorder and Generalized Anxiety Disorder.
- Apply brief narrative intervention to treat PTSD patients.
- Discuss possible barriers and biases which may impact patient care (i.e., race, ethnicity, language, gender identity/orientation, age, socioeconomic status, attitudes, feelings, or other characteristics).
Virtual Meeting- Zoom
Scott Nichols, MD Consultant Psychiatrist, Department of Supportive Care Medicine, Division of Psychiatry, City of Hope
Presenter: Dr. Nichols has indicated that there are no relevant financial relationships.
Dr. Nichols will be discussing the off-label or investigational use of Olanzapine, Risperidone, Propranolol, and Lorazepam.
Planner: Eleana Liou, MPA has indicated that there are no relevant financial relationships.
This presentation and/or comments will provide a balanced, non-promotional, and evidence-based approach to all diagnostic, therapeutic and/or research related content.
CME Committee/Reviewer no relevant financial relationships: Daneng Li, MD
ACCREDITATION STATEMENT: City of Hope is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
CREDIT DESIGNATION: City of Hope designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The following credit type(s) are being offered for this course:
• AMA PRA Category 1 Credit™ 1.0
The following may apply AMA PRA Category 1 Credit™ for license renewal:
Registered Nurses: Nurses may report up to 1.0 credit hours toward the continuing education requirements for license renewal by their state Board of Registered Nurses (BRN). AMA PRA Category 1 Credit™ may be noted on the license renewal application in lieu of a BRN provider number.
Physician Assistants: The National Commission on Certification of Physicians Assistants states that AMA PRA Category 1 Credit™ accredited courses are acceptable for CME requirements for recertification.
- 1.00 AMA PRA Category 1 Credit™City of Hope is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
City of Hope designates this 2024 Science of Caring Grand Rounds | Post Traumatic Stress Disorder in Cancer Patients: Conceptual Overview and Clinical Treatment for a maximum of 1.00 AMA PRA Category 1 Credit™ requirements. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
- 1.00 Attendance