Table 2.
PTSD and symptoms prevalence, region in which the study took place, patients’ ethnicity, number of patients, illness phase, illness stage, and screening instruments
| Reference | Region of the study | Patients’ ethnicity | Number of patients | Illness phase | Illness stage | PTSD prevalence | PTSD symptoms prevalence | Instruments |
|---|---|---|---|---|---|---|---|---|
| Hegel et al (2006)8 | USA | White, Asian | 236 | Presurgical consultation | Stages I, II, III | 10% | The four-item primary care PTSD screen (PC-PTSD) | |
| Mehnert and Koch (2007)9 | Germany | Not specified | 127 | Postsurgery and post-treatment | 2.4% | Structured Clinical Interview for DSM-IV*, IES-R, PCL-C | ||
| Shelby et al (2008)10 | USA | Not specified | 74 | Diagnosis and 18 months later | Stages II and III (node positive) | 3%–14% | Upward of 50% | PTSD Checklist-Civilian Version |
| Elklit and Blum (2011)13 | Denmark | White | 64 | 12 months after diagnosis | 13% | Upward to 75% | Harvard Trauma Questionnaire (HTQ) | |
| O’Connor et al (2011)12 | Denmark | Not immigrant, immigrant | 3343 | 3 and 15 months after surgery | Primary breast cancer | 20.1% 3 months postsurgery, 14.3% 15 months postsurgery | IES | |
| Alkhyatt et al (2012)14 | Iraq | Not specified | 100 | 4–12 months post–cancer treatment | Early stage | 3% | 5% | IES |
| Vin Raviv et al (2013)11 | USA | Asian, Afro-American, White | 1139 | Diagnosis, post-treatment | Nonmetastatic breast cancer | 23% at diagnosis; 16.5% at 4-month follow-up | IES | |
| Arnaboldi et al (2014)4 | Italy | White | 150 | Within 30 days after diagnosis and at 2 years follow-up | Women candidated to a mastectomy procedure | 20% prevalence for intrusion symptoms, 19.1% for avoidance symptoms | IES | |
| Swartzman et al (2017)3 | UK | Caucasian, Middle East, North America | 16,755 | Breast cancer patients in 38 PTSD prevalence studies | 10% | DSM-IV Criteria* | ||
| Wu et al (2016)15 | USA | Caucasian, non-Caucasian | 14,603 | Meta-analysis: prevalence of PTSD among breast cancer patients | 34 observational studies | 0%–32.3% (overall 9.6%) | Various instruments studied on the basis of their PTSD detection rate |
Notes:
DSM-IV criteria for PTSD: the person must have been exposed to, or witnessed a traumatic event that involved actual or threatened death or a threat to the physical integrity of oneself or others and which invoked intense fear, helplessness, or horror in the recipient (Criterion A). Criterion B requires that the individual experiences either intrusive memories, nightmares, a sense of reliving the traumatic event, or psychological and physiological distress when reminded the event. Criterion C requires at least three of avoidance of thoughts, feelings, or reminders of the trauma, inability to recall aspects of the trauma, withdrawal from others, emotional numbing or a sense of foreshortened future. Criterion D stipulates the presence of at least two of the following symptoms: insomnia, irritability, concentration difficulties, hypervigilance, or exaggerated startle response. These symptoms must persist for at least 1 month following exposure to the traumatic event (Criterion E), and they must cause significant impairment to the individual’s functioning (Criterion F).
Abbreviations: DSM-IV, Diagnostic and Statistical Manual of Mental Disorders version IV; IES, Impact of Event Scale; IES-R, IES-Revised; PCL-C, PTSD Checklist-Civilian Version; PTSD, post-traumatic stress disorder.