Lung cancer and posttraumatic stress symptoms: Predictive factors and subgroup analysis

Abstract

Objective: Lung cancer is the most common cancer and the leading cause of cancer death worldwide. Research on the correlation between posttraumatic stress symptoms (PTSSs) and lung cancer is limited. In this study, we intended to study PTSS predictors in patients with lung cancer and their subgroups. Methods: Patients aged ≥ 20 years with lung cancer diagnosis were recruited. We collected information on demographic characteristics, depressive symptoms, and cognitive function, to examine the effect on PTSSs. With the Chinese version of the startle, physiological arousal, anger, and numbness questionnaire, we analyzed the variables to identify the independent correlates of PTSSs and to compare differences among treatment and cancer stage subgroups. Results: A total of 329 lung cancer patients were included with prominent male, below senior high school education level, married status, unemployment, smoking history, non-alcohol drinker, without psychiatric history and comorbid diabetes and hypertension. The correlates of PTSSs were significantly higher in education level (β = 0.197, p < 0.01), cognitive function (β = −0.269, p < 0.001), and depressive symptoms (β = 0.294, p < 0.001). In subgroup analysis, high education level was significantly correlated of PTSSs in different treatment groups surgery group (β = 0.266, p < 0.05), nonsurgery group (β = 0.204, p < 0.05), chemotherapy group (β = 0.189, p < 0.05), and nonchemotherapy group (β = 0.220, p < 0.05). Cognitive function was significantly correlated of PTSSs in different cancer stages in early stage (β = −0.401, p < 0.01) and advanced stage (β = −0.182, p < 0.05). Conclusion: Depressive symptoms, high education level, and the poor cognitive function were significantly associated with PTSSs in patients with lung cancer. Health professionals in oncology should consider psychological burden screening, cognitive function examination, and rehabilitation in clinical practice.