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Post-traumatic Stress Disorder Related to Surgery: Prevalence and Risk Factors

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Comprehensive Guide to Post-Traumatic Stress Disorder

Abstract

The experience of undergoing surgery is a trauma significant enough to result in PTSD for some patients. This chapter reviews the research on factors related to the development of PTSD: patient characteristics (demographic factors, psychiatric history, cognitive appraisal, and coping), disease factors (severity, predictability and controllability of symptoms, curative potential for surgery), and surgical factors (length of stay, recall of traumatic memories), as well as PTSD effects on self-care activities after surgery, recovery, and health outcomes. Interventions that may be effective for reducing the risk of PTSD (intensive case management, giving patients adequate information, providing appropriate control, behavioral techniques to manage acute distress) are discussed.

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Abbreviations

CABG:

Coronary artery bypass graft

CAD:

Coronary artery disease

CBT:

Cognitive behavioral therapy

FI:

Functional independence

ICD:

Implantable cardioverter defibrillator

ICU:

Intensive care unit

MI:

Myocardial infarction

PTG:

Post-traumatic growth

PTS:

Post-traumatic stress

PTSD:

Post-traumatic stress disorder

SCI:

Spinal cord injury

SES:

Socioeconomic status

SSRI:

Selective serotonin reuptake inhibitor

TAU:

Treatment as usual

References

  • Allan JL, Johnston DW, Johnston M, Mant D. Depression and perceived behavioral control are independent predictors of future activity and fitness after coronary syndrome events. J Psychosom Med. 2007;63:501–8.

    Article  Google Scholar 

  • Anastasiou I, Yiannopoulou K, Mihalakis A, et al. Symptoms of acute posttraumatic stress disorder in prostate cancer patients following radical prostatectomy. Am J Mens Health. 2011;5:84–9.

    Article  PubMed  Google Scholar 

  • Anisman H, Merali Z. Understanding stress: characteristics and caveats. Alcohol Res Health. 1999;23:241–9.

    PubMed  Google Scholar 

  • Beyea S. Addressing the trauma of anesthesia awareness. AORN J. 2005;81:603–6.

    Article  PubMed  Google Scholar 

  • Boso M, Politi P, Barale F, Emanuele E. Neurophysiology and neurobiology of the musical experience. Funct Neurol. 2006;21:187–91.

    PubMed  Google Scholar 

  • Boyer BA, Knolls ML, Kafkalas CM, Tollen LG. What is the trauma? Patients’, mothers’ and fathers’ fear and helplessness related to posttraumatic aspects of pediatric SCI. Top Spinal Cord Inj Rehabil. 2000a;6:134–47.

    Article  Google Scholar 

  • Boyer BA, Knolls ML, Kafkalas CM, Tollen LG. Prevalence of posttraumatic stress disorder in patients with pediatric spinal cord injury: relationship to functional independence. Top Spinal Cord Inj Rehabil. 2000b;6:125–33.

    Article  Google Scholar 

  • Boyer BA, Bubel D, Jacobs S, et al. Posttraumatic stress in women with breast cancer and their daughters. Am J Fam Ther. 2002;30:232–338.

    Article  Google Scholar 

  • Boyer BA, Nowcid CA, Ware C. Functional independence in pediatric-onset spinal cord injury: two levels of mediation. Rehabil Psychol. 2012;57:328–36.

    Article  PubMed  Google Scholar 

  • Boyer BA, Matour SJ, Crittenden KB, Larson KA, Cox JM, Link DD. Appraisals of fear, helplessness, and perceived life-threat during emergent cardiac surgery: relationship to pre-surgical depression, trauma history, and posttraumatic stress. J Clin Psychol Med Settings. 2013;20:173–85.

    Article  PubMed  Google Scholar 

  • Buchanan TW, Lovallo WR. Enhanced memory for emotional material following stress-level cortisol treatment in humans. Psychoneuroendocrinology. 2001;26:307–17.

    Article  PubMed  Google Scholar 

  • Cahill L, Prins B, Weber M, McGaugh J. β-adrenergic activation and memory for emotional events. Nature. 1994;371:702–4.

    Article  PubMed  Google Scholar 

  • Caldwell P, Arthur H, Natarajan M, Anand S. Fears and beliefs of patients undergoing cardiac catheterization. Soc Sci Med. 2007;65:1038–48.

    Article  PubMed  Google Scholar 

  • Cavalcanti-Ribeiro P, Andrade-Nascimento M, Morais-De-Jesus M, et al. Post-traumatic stress disorder as a comorbidity: impact on disease outcomes. Expert Rev Neurother. 2012;12:1023–37.

    Article  PubMed  Google Scholar 

  • Chan M, Ho S, Tedeschi R, Leung C. The valence of attentional bias and cancer-related rumination in posttraumatic stress and posttraumatic growth among women with breast cancer. Psychooncology. 2011;20:544–52.

    Article  PubMed  Google Scholar 

  • Ciccone D, Kline A. A longitudinal study of pain and pain catastrophizing in a cohort of National Guard troops at risk for PTSD. Pain. 2012;153:2055–60.

    Article  PubMed  Google Scholar 

  • Cremeans-Smith J, Krupko T, Greene K, Delahanty D. Predicting symptoms of post-traumatic stress among patients undergoing orthopedic surgery on the basis of routinely collected cardiovascular data. J Health Psychol. 2012;18:55–64.

    Article  PubMed  Google Scholar 

  • Dao TK, Chu D, Springer J, et al. Clinical depression, posttraumatic stress disorder, and comorbid depression and posttraumatic stress disorder as risk factors for in-hospital mortality after coronary artery bypass grafting surgery. J Thorac Cardiovasc Surg. 2010;140:606–10.

    Article  PubMed  Google Scholar 

  • Davydow D, Gifford J, Desai S, Needham D, Bienvenu O. Posttraumatic stress disorder in general intensive care unit survivors: a systematic review. Gen Hosp Psychiatry. 2008;30:421–34.

    Article  PubMed Central  PubMed  Google Scholar 

  • Davydow D, Katon W, Zatzick D. Psychiatric morbidity and functional impairments in survivors of burns, traumatic injuries, and ICU stays for other critical illnesses: a review of the literature. Int Rev Psychiatry. 2009;21:531–8.

    Article  PubMed Central  PubMed  Google Scholar 

  • De Geest S, Dobbels F, Fluri C, Paris W, Troosters T. Adherence to the therapeutic regimen in heart, lung, and heart-lung transplant recipients. J Cardiovasc Nurs. 2005;20:S88–98.

    Article  PubMed  Google Scholar 

  • Dew M, Kormos R, Roth L, Murali S, DiMartini A, Griffith BP. Early post-transplant medical compliance and mental health predict physical morbidity and mortality one to three years after heart transplantation. J Heart Lung Transplant. 1999;18:549–62.

    Article  PubMed  Google Scholar 

  • Doerfler L, Paraskos J. Anxiety, posttraumatic stress disorder, and depression in patients with coronary heart disease. J Cardiopulm Rehabil. 2004;24:414–21.

    Article  PubMed  Google Scholar 

  • Doerfler L, Pbert L, Decosimo D. Symptoms of posttraumatic stress disorder following myocardial infarction and coronary artery bypass surgery. Gen Hosp Psychiatry. 1994;16:193–9.

    Article  PubMed  Google Scholar 

  • Ehlers A, Mayou RA, Bryant B. Cognitive predictors of posttraumatic stress disorder in children: results of a prospective longitudinal study. Behav Res Ther. 2003;41:1.

    Article  PubMed  Google Scholar 

  • Eshelman A, Mason S, Nemeh H, Williams C. LVAD destination therapy: applying what we know about psychiatric evaluation and management from cardiac failure and transplant. Heart Fail Rev. 2009;14:21–8.

    Article  PubMed  Google Scholar 

  • Fabian I, Abudy A, Kinori M, et al. Diagnosis of posttraumatic stress disorder after surgery for primary rhegmatogenous retinal detachment. Retin J Ret Vis Dis. 2013;33:111–9.

    Google Scholar 

  • Fusar-Poli P, Martinelli V, Klersy C, et al. Depression and quality of life in patients living 10 to 18 years beyond heart transplantation. J Heart Lung Transplant. 2005;24:2269–78.

    Article  PubMed  Google Scholar 

  • Guimaro M, Lacerda S, Aguilar M, Karam C, Kernkraut A, Ferraz-Neto BH. Post-traumatic stress disorders, mood disorders, and quality of life in transplant recipients with acute liver failure. Transplant Proc. 2011;43:187–8.

    Article  PubMed  Google Scholar 

  • Hudetz J, Gandhi S, Iqbal Z, et al. History of post-traumatic stress disorder is associated with impaired neuropsychometric performance after coronary artery surgery. J Cardiothorac Vasc Anesth. 2010;24:964–8.

    Article  PubMed  Google Scholar 

  • Hyland P, Shevlin M, Adamson G, Boduszek D. The role of trauma-specific irrational beliefs and sociodemographic risk factors in posttraumatic stress responses. J Ration Emot Cogn Behav Ther. 2013;31:152–66.

    Article  Google Scholar 

  • Kapa S, Rotondi-Trevisan D, Mariano Z, et al. Psychopathology in patients with ICDs over time: results of a prospective study. Pacing Clin Electrophysiol. 2009;33:198–208.

    Article  PubMed  Google Scholar 

  • Karanci A, Dirik G. Predictors of pre- and postoperative anxiety in emergency surgery patients. J Psychosom Res. 2003;55:363–9.

    Article  PubMed  Google Scholar 

  • Kessler RC, McGonagle KA, Zhao S, et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Arch Gen Psychiatry. 1994;51:8–19.

    Article  PubMed  Google Scholar 

  • King K. A review of the effects of guided imagery on cancer patients with pain. Complement Health Pract Rev. 2010;15:98–107.

    Google Scholar 

  • Koivula M, Hautamaki-Lamminen K, Åstedt-Kurki P. Predictors of fear and anxiety nine years after coronary artery bypass grafting. J Adv Nurs. 2010;66:595–606.

    Article  PubMed  Google Scholar 

  • Krantz DS, McCeney MK. Effects of psychological and social factors on organic disease: a critical assessment of research on coronary heart disease. Annu Rev Psychol. 2002;53:341–69.

    Article  PubMed  Google Scholar 

  • Lawndy S, Withagen M, Kluivers K, Vierhout M. Between hope and fear: patient’s expectations prior to pelvic organ prolapse surgery. Int Urogynecol J. 2011;22:1159–63.

    Article  PubMed Central  PubMed  Google Scholar 

  • Liberzon I, Abelson J, Amdur R, et al. Increased psychiatric morbidity after abdominal aortic surgery: risk factors for stress-related disorders. Yearb Vasc Surg. 2006;43:137–8.

    Google Scholar 

  • Martin A, Halket E, Asmundson G, Flora D, Katz J. Posttraumatic stress symptoms and the diathesis-stress model of chronic pain and disability in patients undergoing major surgery. Clin J Pain. 2010;26:518–27.

    Article  PubMed  Google Scholar 

  • Mashour G, Avidan M. Pharmacologic approaches to the prevention of intraoperative awareness. Expert Rev Neurother. 2011;11:611–3.

    Article  PubMed  Google Scholar 

  • Mehnert A, Koch U. Prevalence of acute and post-traumatic stress disorder and comorbid mental disorders in breast cancer patients during primary cancer care: a prospective study. Psychooncology. 2007;16:181–8.

    Article  PubMed  Google Scholar 

  • Miller SM. Controllability and human stress: method, evidence and theory. Behav Res Ther. 1979;17:287–306.

    Article  PubMed  Google Scholar 

  • Moerman N, Bonke B, Oosting J. Awareness and recall during general anesthesia. Anesthesiology. 1993;79:454–64.

    Article  PubMed  Google Scholar 

  • Morris MC, Rao U. Psychobiology of PTSD in the acute aftermath of trauma: integrating research on coping, HPA function and sympathetic nervous system activity. Asian J Psychiatry. 2013;6:3–21.

    Article  Google Scholar 

  • Nagata S, Funakosi S, Amae S, et al. Posttraumatic stress disorder in mothers of children who have undergone surgery for congenital disease at a pediatric surgery department. J Pediatr Surg. 2008;43:1480–6.

    Article  PubMed  Google Scholar 

  • O’Connor M, Christensen S, Jensen A, Moller S, Zachariae R. How traumatic is breast cancer? Post-traumatic stress symptoms (PTSS) and risk factors for severe PTSS at 3 and 15 months after surgery in a nationwide cohort of Danish women treated for primary breast cancer. Br J Cancer. 2011;104:419–26.

    Article  PubMed Central  PubMed  Google Scholar 

  • Olatunji B, Armstrong T, Fan Q, Zhao M. Risk and resiliency in posttraumatic stress disorder: distinct roles of anxiety and disgust sensitivity. Psychol Trauma Theory Res Pract Policy. 2014;6:50–5.

    Article  Google Scholar 

  • Osterman J, Hopper J, Heran W, Keane T, van der Kolk B. Awareness under anesthesia and the development of posttraumatic stress disorder. Gen Hosp Psychiatry. 2001;23:198–204.

    Article  PubMed  Google Scholar 

  • Oxlad M, Wade TD. Longitudinal risk factors for adverse psychological functioning six months after coronary artery bypass graft surgery. J Health Psychol. 2008;13:79–92.

    Article  PubMed  Google Scholar 

  • Panagopoulou E, Maes S, Tyrodimos E, Benos A. Symptoms of traumatic stress after coronary artery bypass grafting. Int J Behav Med. 2008;15:227–31.

    Article  PubMed  Google Scholar 

  • Pereira M, Figueiredo A, Fincham F. Anxiety, depression, traumatic stress and quality of life in colorectal cancer after different treatments: a study with Portuguese patients and their partners. Eur J Oncol Nurs. 2012;16:227–32.

    Article  Google Scholar 

  • Petrie M, Zatzick D. Collaborative care interventions in general trauma patients. Oral Maxillofac Surg Clin North Am. 2010;22:261–7.

    Article  PubMed Central  PubMed  Google Scholar 

  • Posluszny D, Edwards R, Dew M, Baum A. Perceived threat and PTSD symptoms in women undergoing surgery for gynecologic cancer or benign conditions. Psychooncology. 2011;20:783–7.

    Article  PubMed  Google Scholar 

  • Post-traumatic stress disorders; study: one-fifth of spine surgery patients develop PTSD symptoms. NewsRx Health Sci. 2012:166. http://0-search.proquest.com.libcat.widener.edu/docview/1095693024?accountid=29103.

  • Powell R, Johnston M, Smith W, et al. Rehabilitation following surgery: clinical and psychological predictors of activity limitations. Rehabil Psychol. 2013;58:350–60.

    Article  PubMed  Google Scholar 

  • Prendergast K, Cullen-Drill M. Anesthesia awareness-induced posttraumatic stress disorder. J Psychosoc Nurs Ment Health Serv. 2012;50:39–44.

    Article  PubMed  Google Scholar 

  • Ramchand R, Marshall G, Schell T, Jaycox L. Post-traumatic stress and physical functioning: a longitudinal study of injured survivors of community violence. J Consult Clin Psychol. 2005;76:668–76.

    Article  Google Scholar 

  • Richter J, Waydhas C, Pajonk F. Incidence of post traumatic stress disorder after prolonged surgical intensive care unit treatment. Psychosomatics. 2006;47:223–30.

    Article  PubMed  Google Scholar 

  • Rothenhausler H. The effects of cardiac surgical procedures on health-related quality of life, cognitive performance, and emotional status outcomes: a prospective 6-month follow-up study. Psychiatr Danub. 2010;22:135–6.

    PubMed  Google Scholar 

  • Rothenhausler H, Grieser B, Nollert G, Reichart B, Schelling G, Kapfhammer HP. Psychiatric and psychosocial outcome of cardiac surgery with cardiopulmonary bypass: a prospective 12-month follow-up study. Gen Hosp Psychiatry. 2005;27:18–28.

    Article  PubMed  Google Scholar 

  • Rozanski A, Blumenthal JA, Kaplan J. Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation. 1999;99:2192–217.

    Article  PubMed  Google Scholar 

  • Salmon P, Hill J, Krespi R, Clark L, Fisher J, Holcombe C. The role of child abuse and age in vulnerability to emotional problems after surgery for breast cancer. Eur J Cancer. 2006;42:2517–23.

    Article  PubMed  Google Scholar 

  • Schelling G, Richter M, Roozendaal B, et al. Exposure to high stress in the intensive care unit may have negative effects on health-related quality-of-life outcomes after cardiac surgery. Crit Care Med. 2003;31:1971–80.

    Article  PubMed  Google Scholar 

  • Schreiber S, Soskolne V, Kozohovitch H, Deviri E. Holocaust survivors coping with open heart surgery decades later: posttraumatic symptoms and quality of life. Gen Hosp Psychiatry. 2004;26:443–52.

    Article  PubMed  Google Scholar 

  • Sime A. Relationship of preoperative fear, type of coping, and information received about surgery to recovery from surgery. J Pers Soc Psychol. 1976;34:716–24.

    Article  PubMed  Google Scholar 

  • Skrzypulec V, Tobor E, Drosdzol A, Nowosielski K. Biopsychosocial functioning of women after mastectomy. J Clin Nurs. 2008;18:613–9.

    Article  PubMed  Google Scholar 

  • Spindler H, Pedersen SS. Posttraumatic stress disorder in the wake of heart disease: prevalence, risk factors, and future research directions. Psychosom Med. 2005;67:715–23.

    Article  PubMed  Google Scholar 

  • Stoll C, Schelling G, Goetz AE, et al. Health-related quality of life and post-traumatic stress disorder in patients after cardiac surgery and intensive care treatment. J Thorac Cardiovasc Surg. 2000;120:505–12.

    Article  PubMed  Google Scholar 

  • Stukas AS, Dew M, Switzer G, DiMartini A, Kormos R, Griffith BP. PTSD in heart transplant recipients and their primary family caregivers. Psychosomatics. 1999;40:212–21.

    Article  PubMed  Google Scholar 

  • Tarsitani L, DeSantis V, Mistretta M, et al. Treatment with β-blockers and incidence of post-traumatic stress disorder after cardiac surgery: a prospective observational study. J Cardiothorac Vasc Anesth. 2012;26:265–9.

    Article  PubMed  Google Scholar 

  • Taylor C, Richardson A, Cowley S. Surviving cancer treatment: an investigation of the experience of fear about, and monitoring for, recurrence in patients following treatment for colorectal cancer. Eur J Oncol Nurs. 2011;15:243–9.

    Article  PubMed  Google Scholar 

  • Toren P, Horesh N. Psychiatric morbidity in adolescents operated in childhood for congenital cyanotic heart disease. J Pediatr Child Health. 2007;43:662–6.

    Article  Google Scholar 

  • Van Stegeren A, Everaerd W, Gooren L. The effect of beta-adrenergic blockade after encoding on memory of an emotional event. Psychopharmacology (Berl). 2002;163:202–12.

    Article  Google Scholar 

  • Voshaar R, Banerjee S, Horan M, et al. Fear of falling more important than pain and depression for functional recovery after surgery for hip fracture in older people. Psychol Med. 2006;36:1635–45.

    Article  Google Scholar 

  • Wade T, Nehmy T, Koczwara B. Predicting worries about health after breast cancer surgery. Psychooncology. 2005;14:503–9.

    Article  PubMed  Google Scholar 

  • Weissman MM, Bland RC, Canino GJ, et al. Cross-national epidemiology of major depression and bipolar disorder. J Am Med Assoc. 1996;276:293–9.

    Article  Google Scholar 

  • Yu SH, Chen SH, Chang KJ. Rumination predicting depression and PTSD symptoms in postoperative breast cancer patients. Chin J Psychol. 2008;50:289–302.

    Google Scholar 

  • Zatzick D, Kang S, Kim S, et al. Patients with recognized psychiatric disorders in trauma surgery: incidence, inpatient length of stay, and cost. J Trauma. 2000;49:487–95.

    Article  PubMed  Google Scholar 

  • Zatzick D, Russo J, Katon W. Somatic, posttraumatic stress, and depressive symptoms among injured patients treated in trauma surgery. Psychosomatics. 2003;44:479–84.

    Article  PubMed  Google Scholar 

  • Zatzick D, Jurkovich G, Rivara F, et al. A randomized stepped care intervention trial targeting posttraumatic stress disorder for surgically hospitalized injury survivors. Ann Surg. 2013;257:390–9.

    Article  PubMed Central  PubMed  Google Scholar 

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Authors and Affiliations

  1. Institute for Graduate Clinical Psychology, Widener University, One University Place, Chester, PA, 19013, USA

    Kate G. Deatrich & Bret A. Boyer

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  1. Kate G. Deatrich
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  2. Bret A. Boyer
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Correspondence to Bret A. Boyer .

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Editors and Affiliations

  1. Buckinghamshire New University, Uxbridge, Middlesex, United Kingdom

    Colin R. Martin

  2. Kings College, London, United Kingdom

    Victor R. Preedy

  3. University of Westminster, London, United Kingdom

    Vinood B. Patel

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Deatrich, K.G., Boyer, B.A. (2015). Post-traumatic Stress Disorder Related to Surgery: Prevalence and Risk Factors. In: Martin, C., Preedy, V., Patel, V. (eds) Comprehensive Guide to Post-Traumatic Stress Disorder. Springer, Cham. https://doi.org/10.1007/978-3-319-08613-2_42-1

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  • DOI: https://doi.org/10.1007/978-3-319-08613-2_42-1

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