Posttraumatic stress disorder is common among patients with familial adenomatous polyposis, for whom medical trauma from surgery could have been a trigger, according to new research presented at the American Society of Colon and Rectal Surgeons Annual Scientific Meeting.
Investigators concluded that professional counseling is therefore essential in the comprehensive treatment of patients with FAP, but this need is often unmet.
James M. Church
“This is an extremely important study that is quite novel. It documents the existence of significant mental health concerns in patients with FAP, and the lack of support they suffer because of a lack of awareness among caregivers,” James M. Church, MD, of the department of colorectal surgery at the Cleveland Clinic, told Healio Gastroenterology. “About 20% suffer from symptoms characteristic of PTSD and need specific counseling and therapy.”
Church and colleagues developed an online mental health survey that included questions about the four symptoms of PTSD, including re-experiencing symptoms, avoiding symptoms, hyper-arousal symptoms and negative changes in beliefs and feelings. Patients who reported having all four symptoms were defined as having PTSD, and patients who reported having three out of four symptoms were defined as having partial PTSD. Additional questions on psychosocial symptoms and quality of life were analyzed based on PTSD status.
After sending the survey to all FAP patients in a local registry, 79 completed it.
Overall, 57 (72.2%) of the patients reported having psychosocial symptoms, including nine (11.4%) who met study criteria for PTSD and eight (10.1%) who met criteria for partial PTSD.
On average, those with PTSD reported 9.3 psychosocial symptoms each vs. 8.3 for those with partial PTSD and 2.3 for those without PTSD (P < .05).
Quality of life scores did not vary significantly across PTSD status. On a 7-point scale (with 7 being the best), mean QOL scores were 4.6 for PTSD patients, 5.3 for partial PTSD patients and 4.9 for patients without PTSD.
Patients with PTSD and partial PTSD accounted for a significant proportion of all patients who reported having psychosocial symptoms, and all six FAP patients who reported having suicidal thoughts met criteria for PTSD. The correlation between suicidal ideation and PTSD in FAP patients warrants further research, the researchers noted.
They concluded that FAP patients with PTSD are significantly affected by psychosocial symptoms and should receive professional counseling.
“This is groundbreaking work and the response to it should be of great help to suffering patients and their families,” Church said. – by Adam Leitenberger
Church J, Wood E. Abstract PD18. Presented at: American Society of Colon and Rectal Surgeons Annual Scientific Meeting; June 10-14, 2017; Seattle.
Disclosures: The researchers report no relevant financial disclosures.