Post-traumatic stress symptoms in cancer patients during the COVID-19 pandemic: a one-year longitudinal study

  1. Etienne Bastien
  2. Sophie Lefèvre-Arbogast
  3. Justine Lequesne
  4. François Gernier
  5. François Cherifi
  6. Olivier Rigal
  7. Lydia Guittet
  8. Jean-Michel Grellard
  9. Giulia Binarelli
  10. Marie Lange
  11. Marie Fernette
  12. Laure Tron
  13. Adeline Morel
  14. Doriane Richard
  15. Bénédicte Griffon
  16. Alexandra Leconte
  17. Florian Quilan
  18. Louis-Ferdinand Pépin
  19. Fabrice Jardin
  20. Marianne Leheurteur
  21. Audrey Faveyrial
  22. Bénédicte Clarisse
  23. Florence Joly

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Abstract

Background

Cancer patients may be particularly vulnerable to psychological consequences of the COVID-19 pandemic and successive lockdowns. We studied the prevalence and evolution of post-traumatic stress disorder (PTSD) symptoms in cancer patients during the pandemic waves, and investigated factors associated with high symptoms.

Methods

COVIPACT is a one-year longitudinal prospective study of French patients with solid/hematologic malignancy receiving treatment during the first nationwide lockdown. PTSD symptoms were measured every 3 months from April 2020 using the Impact of Event Scale-Revised. Patients also completed validated questionnaires on quality of life (QoL), cognitive complaints and insomnia, and a survey on their COVID-19 lockdown experience.

Results

Longitudinal analyses involved 386 patients with at least one PTSD assessment after baseline (median age 63, 76% female). Among them, 21.5% had moderate/severe PTSD symptoms during the first lockdown. The rate of patients reporting PTSD symptoms decreased at lockdown release (13.6%), increased again at second lockdown (23.2%), and slightly declined from the second release period (22.7%) to the third lockdown (17.5%). Patients were grouped into three trajectories of evolution. Most patients had stable low symptoms throughout the period, 6% had high baseline symptoms slowly decreasing over time, and 17.6% had moderate symptoms worsening during second lockdown. Female sex, feeling socially isolated, worrying about COVID-19 infection, and using psychotropic drugs were associated with PTSD symptoms. PTSD symptoms were associated with impaired QoL, sleep and cognition.

Conclusions

Around a quarter of cancer patients presented high and persistent PTSD symptoms over the first year of the COVID-19 pandemic and may benefit from psychological support.

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    SciScore for 10.1101/2022.01.11.22269053: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: Ethical Approval: Approval for the study was obtained from the local ethics committee (ref. 220 C07; South Mediterranean II Committee for the Protection of Persons).
    Field Sample Permit: The study was conducted in compliance with the French research standard (MR-003 “Research in the Field of Health Without Collection of Consent”; compliance commitment to MR-003 for the François Baclesse Center [no. 2146328 v.0, dated from January 26, 2018]).
    Sex as a biological variablenot detected.
    RandomizationModels included an intercept representing baseline symptoms, a discrete time representing change of symptoms over time, and a random intercept for each patient to account for inter-individual variability.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: We found the following clinical trial numbers in your paper:

    IdentifierStatusTitle
    NCT104366154Trial number did not resolve on clinicaltrials.gov. Is the number correct?NA
    NCT04366154Active, not recruitingImpact of the COVID-19 Infectious Epidemic on the Management…

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

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  2. Version published to 10.1101/2022.01.11.22269053v1 on medRxiv