Post-traumatic stress disorder and cancer.
TL;DR: Treatment of cancer-related PTSD should be approached with caution and be informed by existing evidence-based approaches for traumatic stress, and diagnostic issues should be taken into account.
About: This article is published in The Lancet Psychiatry.The article was published on 2017-04-01 and is currently open access. It has received 255 citations till now. The article focuses on the topics: Traumatic stress & Psychiatric history.
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TL;DR: Immunostimulatory chemotherapeutics stand out as promising partners for combination regimens involving immune checkpoint inhibitors, although additional research is required to identify the optimal regimens.
Abstract: Conventional chemotherapeutics have been developed into clinically useful agents based on their ability to preferentially kill malignant cells, generally owing to their elevated proliferation rate. Nonetheless, the clinical activity of various chemotherapies is now known to involve the stimulation of anticancer immunity either by initiating the release of immunostimulatory molecules from dying cancer cells or by mediating off-target effects on immune cell populations. Understanding the precise immunological mechanisms that underlie the efficacy of chemotherapy has the potential not only to enable the identification of superior biomarkers of response but also to accelerate the development of synergistic combination regimens that enhance the clinical effectiveness of immune checkpoint inhibitors (ICIs) relative to their effectiveness as monotherapies. Indeed, accumulating evidence supports the clinical value of combining appropriately dosed chemotherapies with ICIs. In this Review, we discuss preclinical and clinical data on the immunostimulatory effects of conventional chemotherapeutics in the context of ICI-based immunotherapy.
536 citations
340 citations
TL;DR: More research is urgently needed into the possible impacts of long-term and late effects of cancer treatment on mental health and how these may be prevented, as increasing numbers of people live with and beyond cancer.
Abstract: A cancer diagnosis can have a substantial impact on mental health and wellbeing. Depression and anxiety may hinder cancer treatment and recovery, as well as quality of life and survival. We argue that more research is needed to prevent and treat co-morbid depression and anxiety among people with cancer and that it requires greater clinical priority. For background and to support our argument, we synthesise existing systematic reviews relating to cancer and common mental disorders, focusing on depression and anxiety. We searched several electronic databases for relevant reviews on cancer, depression and anxiety from 2012 to 2019. Several areas are covered: factors that may contribute to the development of common mental disorders among people with cancer; the prevalence of depression and anxiety; and potential care and treatment options. We also make several recommendations for future research. Numerous individual, psychological, social and contextual factors potentially contribute to the development of depression and anxiety among people with cancer, as well as characteristics related to the cancer and treatment received. Compared to the general population, the prevalence of depression and anxiety is often found to be higher among people with cancer, but estimates vary due to several factors, such as the treatment setting, type of cancer and time since diagnosis. Overall, there are a lack of high-quality studies into the mental health of people with cancer following treatment and among long-term survivors, particularly for the less prevalent cancer types and younger people. Studies that focus on prevention are minimal and research covering low- and middle-income populations is limited. Research is urgently needed into the possible impacts of long-term and late effects of cancer treatment on mental health and how these may be prevented, as increasing numbers of people live with and beyond cancer.
278 citations
Additional excerpts
...anxiety, including post-traumatic stress disorder [20]....
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TL;DR: Kroemer et al. as mentioned in this paper found that normal cells succumbing to conditions that promote the formation of post-translational neoantigens (for example, oxidative stress) can also drive at least some degree of antigen-specific immunity, pointing to a novel implication of ICD in the etiology of non-infectious, non-malignant disorders linked to autoreactivity.
Abstract: Dying mammalian cells emit numerous signals that interact with the host to dictate the immunological correlates of cellular stress and death. In the absence of reactive antigenic determinants (which is generally the case for healthy cells), such signals may drive inflammation but cannot engage adaptive immunity. Conversely, when cells exhibit sufficient antigenicity, as in the case of infected or malignant cells, their death can culminate with adaptive immune responses that are executed by cytotoxic T lymphocytes and elicit immunological memory. Suggesting a key role for immunogenic cell death (ICD) in immunosurveillance, both pathogens and cancer cells evolved strategies to prevent the recognition of cell death as immunogenic. Intriguingly, normal cells succumbing to conditions that promote the formation of post-translational neoantigens (for example, oxidative stress) can also drive at least some degree of antigen-specific immunity, pointing to a novel implication of ICD in the etiology of non-infectious, non-malignant disorders linked to autoreactivity. Immunogenic cell death (ICD) is central to both homeostatic and pathophysiological events. Kroemer et al. review the mechanisms of ICD and its role in therapy and disease.
251 citations
TL;DR: In this paper, a sample of online participants (N = 1,040), in five western countries, were asked to indicate the COVID-19 events they had been directly exposed to, events they anticipated would happen in the future, and other forms of indirect exposure such as through media coverage.
Abstract: The COVID-19 pandemic does not fit into prevailing Post-traumatic Stress Disorder (PTSD) models, or diagnostic criteria, yet emerging research shows traumatic stress symptoms as a result of this ongoing global stressor. Current pathogenic event models focus on past, and largely direct, trauma exposure to certain kinds of life-threatening events. Yet, traumatic stress reactions to future, indirect trauma exposure, and non-Criterion A events exist, suggesting COVID-19 is also a traumatic stressor which could lead to PTSD symptomology. To examine this idea, we asked a sample of online participants (N = 1,040), in five western countries, to indicate the COVID-19 events they had been directly exposed to, events they anticipated would happen in the future, and other forms of indirect exposure such as through media coverage. We then asked participants to complete the Posttraumatic Stress Disorder Checklist-5, adapted to measure pre/peri/post-traumatic reactions in relation to COVID-19. We also measured general emotional reactions (e.g., angry, anxious, helpless), well-being, psychosocial functioning, and depression, anxiety, and stress symptoms. We found participants had PTSD-like symptoms for events that had not happened and when participants had been directly (e.g., contact with virus) or indirectly exposed to COVID-19 (e.g., via media). Moreover, 13.2% of our sample were likely PTSD-positive, despite types of COVID-19 "exposure" (e.g., lockdown) not fitting DSM-5 criteria. The emotional impact of "worst" experienced/anticipated events best predicted PTSD-like symptoms. Taken together, our findings support emerging research that COVID-19 can be understood as a traumatic stressor event capable of eliciting PTSD-like responses and exacerbating other related mental health problems (e.g., anxiety, depression, psychosocial functioning, etc.). Our findings add to existing literature supporting a pathogenic event memory model of traumatic stress.
226 citations
References
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11 Jun 2013
113,134 citations
01 Jan 2012
4,948 citations
TL;DR: The results suggest that peritraumatic psychological processes, not prior characteristics, are the strongest predictors of PTSD.
Abstract: A review of 2,647 studies of posttraumatic stress disorder (PTSD) yielded 476 potential candidates for a meta-analysis of predictors of PTSD or of its symptoms. From these, 68 studies met criteria for inclusion in a meta-analysis of 7 predictors: (a) prior trauma, (b) prior psychological adjustment, (c) family history of psychopathology, (d) perceived life threat during the trauma, (e) posttrauma social support, (f) peritraumatic emotional responses, and (g) peritraumatic dissociation. All yielded significant effect sizes, with family history, prior trauma, and prior adjustment the smallest (weighted r = .17) and peritraumatic dissociation the largest (weighted r = .35). The results suggest that peritraumatic psychological processes, not prior characteristics, are the strongest predictors of PTSD.
2,995 citations
Book•
24 Apr 1995TL;DR: In this article, the authors present a three-phase EMDR protocol, where phase one: client history, phase two and three: preparation and assessment, phase four to seven: desensitization, installation, body scan and closure, phase eight: reevaluation and the use of the EMDR Standard Three-Pronged Protocol.
Abstract: Preface. Background. Adaptive Information Processing: The Model as a Working Hypothesis. Components of EMDR Treatment and Basic Treatment Effects. Phase One: Client History. Phases Two and Three: Preparation and Assessment. Phases Four to Seven: Desensitization, Installation, Body Scan, and Closure. Working with Abreaction and Blocks. Phase Eight: Re-evaluation and the Use of the EMDR Standard Three-Pronged Protocol. Protocols and Procedures for Special Situations. The Cognitive Interweave: A Proactive Strategy for Working with Challenging Clients. Selected Populations. Theory, Research, and Clinical Implications. Appendices: A. Clinical Aids. B. Client Safety. C. EMDR Resources.
1,614 citations
Book•
20 Jun 1995
TL;DR: The Uses of Suffering Religious and Psychological Roots The Negative Consequences of Trauma Psychological Growth from Trauma Research Findings Personality Characteristics and Successful Coping Tasks and Cognitive Processes in Coping with Trauma How Growth Happens A Model for Coping With Trauma Support and Intervention Research Directions Guideposts for People Challenged by Trauma
Abstract: The Uses of Suffering Religious and Psychological Roots The Negative Consequences of Trauma Psychological Growth from Trauma Research Findings Personality Characteristics and Successful Coping Tasks and Cognitive Processes in Coping with Trauma How Growth Happens A Model for Coping with Trauma Support and Intervention Research Directions Guideposts for People Challenged by Trauma
1,608 citations