Post-Traumatic Stress Disorder and Health-Related Quality of Life in Patients and Their Significant Others Facing Lung Cancer Diagnosis: Intrusive Thoughts as Key Factors


Purpose: 1) to determine the level of post-traumatic stress disorder (PTSD) by means of impact of event scale (IES) in patients for whom lung cancer has been diagnosed for the first time and compare this level in patients having learnt that they affected by chronic obstructive pulmonary disease (COPD); 2) to compare PTSD in patients and their significant others facing a diagnosis of lung cancer; 3) to determine whether or not IES and General Health Questionnaire 28 (GHQ-28) correlate. Methods: This prospective survey-study included 41 consecutive patients who learnt that they were afflicted by primary lung cancer. IES and GHQ-28 were answered once between four and five weeks following medical appointment. The significant others (n = 16) who were present during the lung cancer diagnostic appointment were also invited to complete similar questionnaires. Control group consisted of 19 patients with chronic asthma or COPD. Results: Following a lung cancer diagnosis, patients and their significant others are indistinctly affected by a high level of PTSD. These two groups had a higher frequency of high IES total score when compared with COPD patients. The IES intrusion subscale score significantly differed among groups: median [IR] values: 20 [12 - 26]; 15 [9 - 22]; 7 [5 - 15] for significant others, cancer patients and COPD patients respectively; P = 0.02). IES and GHQ-28 inversely correlated. Conclusion: Patients and significant others facing a diagnosis of lung cancer are at high risk of PTSD. The level of IES intrusion in persons facing lung cancer increases emotional distress that in turn affects quality of life.

Share and Cite:

Pujol, J. , Plassot, C. , Mérel, J. , Arnaud, E. , Launay, M. , Daurès, J. & Boulze, I. (2013). Post-Traumatic Stress Disorder and Health-Related Quality of Life in Patients and Their Significant Others Facing Lung Cancer Diagnosis: Intrusive Thoughts as Key Factors. Psychology, 4, 1-7. doi: 10.4236/psych.2013.46A1001.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Bell, K., Salmon, A., Bowers, M., Bell, J., & McCullough, L. (2010). Smoking, stigma and tobacco “denormalization”: Further reflections on the use of stigma as a public health tool. Social Science & Medicine’s Stigma, Prejudice, Discrimination and Health, 70, 795-799. doi:10.1016/j.socscimed.2009.09.060
[2] Bolognini, M., Bettschart, W., Zehndergubler, M., & Rossier, L. (1989). The validity of the french version of the GHQ-28 and psydis in a community sample of 20 years olds in Switzerland. European Archives of Psychiatry and Neurological Sciences, 238, 161-168. doi:10.1007/BF00451005
[3] Burris, S. (2006). Stigma and the law. Lancet, 367, 529-531. doi:10.1016/S0140-6736(06)68185-3
[4] Chapple, A., Ziebland, S., & McPherson, A. (2004). Stigma, shame, and blame experienced by patients with lung cancer: Qualitative study. British Medical Journal, 328, 1470. doi:10.1136/bmj.38111.639734.7C
[5] Dancey, J., Zee, B., & Osoba, D. (1997). Quality of life scores: An independent prognostic variable in a general population of cancer patients receiving chemotherapy. The National Cancer Institute of Canada Clinical Trials Group. Quality of Life Research, 6, 151-158. doi:10.1023/A:1026442201191
[6] Ganz, P. A., Lee, J. J., & Siau, J. (1991). Quality of life assessment. An independent prognostic variable for survival in lung cancer. Cancer, 67, 3131-3135. doi:10.1002/1097-0142(19910615)67:12<3131::AID-CNCR2820671232>3.0.CO;2-4
[7] Gaugler, J. E., Given, W. C., Linder, J., Kararia, R., Tucker, G., & Regine, W. F. (2008). Work gender and stress in family cancer caregiving. Support Care Cancer, 16, 347-357. doi:10.1007/s00520-007-0331-y
[8] Goldberg, D. P., & Hillier, V. F. (1979). A scale version of the General Health Questionnaire. Psychological Medicine, 9, 139-145. doi:10.1017/S0033291700021644
[9] Gralla, R. J., & Thatcher, N. (2004). Quality-of-life assessment in advanced lung cancer: Considerations for evaluation in patients receiving chemotherapy. Lung Cancer, 46, S41-S47. doi:10.1016/S0169-5002(04)80040-0
[10] Gralla, R. J. (2012). Coming of age for monitoring quality of life and patient-reported outcomes. Journal of Thoracic Oncology, 7, 8-9. doi:10.1097/JTO.0b013e31823f12a3
[11] Haagsma, J. A., Polinder, S., Olff, M., Toet, H., Bonsel, G. J., & Van Beeck, E. F. (2012). Postraumatic stress symptoms and health-related quality of life: A two year follow up study of injury treated at the mergency department. BMC Psychiatry, 12, 1. doi:10.1186/1471-244X-12-1
[12] Horowitz, M. J., Wilner, N. R., & Alvarez, W. (1979). Impact of event scale: A measure of subjective stress. Psychosomatic Medicine, 41, 209-218.
[13] Jacobsen, P. B., & Holland, J. C. (1991). The stress of cancer: Psychological responses to diagnosis and treatment. In: C. I. Cooper, & M. Watson (Eds.), Cancer and stress: Psychological, biological and coping studies (pp. 147-169). Chichester: Wiley.
[14] Kaasa, S., Malt, U., Hagen, S., Wist, E., Moum, T., & Kvikstad, A. (1993). Psychological distress in cancer patients with advanced disease. Radiotherapy & Oncology, 27, 193-197. doi:10.1016/0167-8140(93)90073-H
[15] Koopman, C., Classen, C., & Spiegel, D. (1994). Predictors of posttraumatic stress symptoms among survivors of the Oakland/Berkeley, Calif., firestorm. American Journal of Psychiatry, 151, 888-894.
[16] Lloyd, S., Watson, M., Waites, B., Meyer, L., Eeles, R., Ebbs, S., & Tylee, A. (1996). Familial breast cancer: A controlled study of risk perception, psychological morbidity and health beliefs in women attending for genetic counseling. British Journal of Cancer, 74, 482-487. doi:10.1038/bjc.1996.387
[17] LoConte, N. K., Else-Quest, N. M., Eickhoff, J., Hyde, J., & Schiller, J. H. (2008). Assessment of guilt and shame in patients with non-small cell lung cancer compared with patients with breast and prostate cancer. Clinical Lung Cancer, 9, 171-178. doi:10.3816/CLC.2008.n.026
[18] McBride, C. M., Clipp, E., Peterson, B. L., Lipkus, I. M., & Demark-Wahnefried, W. (2000). Psychological impact of diagnosis and risk reduction among cancer survivors. Psycho-Oncology, 9, 418-427. doi:10.1002/1099-1611(200009/10)9:5<418::AID-PON474>3.0.CO;2-E
[19] McCaul, K. D., Branstetter, A. D., O’Donnell, S. M., Jacobson, K., & Quinlan, K. B. (1998). A descriptive study of breast cancer worry. Journal of Behavioral Medicine, 6, 565-557. doi:10.1023/A:1018748712987
[20] Mehnert, A., & Koch, U. (2007). Prevalence of acute and post-traumatic stress disorder and comorbid mental disorders in breast cancer patients during primary cancer care: A prospective study. Psychooncology, 16, 181-188. doi:10.1002/pon.1057
[21] Norum, J., & Wist, E. (1996). Psychological distress in survivors of Hodgkin’disease. Support Care Cancer, 4, 191-195. doi:10.1007/BF01682339
[22] Ostlund, U., Wennman-Larsen, A., Persson, C., Gustavsson, P., & Wengstrom, Y. (2010). Mental health in significant others of patients dying from lung cancer. Psycho-Oncology, 19, 29-37. doi:10.1002/pon.1433
[23] Pujol, J. L., & Quantin, X. (2009). Time to diagnosis of lung cancer: Technical and pyschological factors that slow down diagnostic and treatment timelines. Journal of Thoracic Oncology, 4, 1192-1194. doi:10.1097/JTO.0b013e3181b88045
[24] Steinglass, P., & Gerrity, E. (1990). Natural disasters and post-traumatic stress disorder: Short-term versus long-term recovery in two disaster-affected communities. Journal of Applied Social Psychology, 20, 1746-1765. doi:10.1111/j.1559-1816.1990.tb01509.x
[25] Sundin, E. C., & Horowitz, M. J. (2003). Horowitz’s impact of event scale evaluation of 20 years of use. Psychosomatic Medicine, 65, 870-876. doi:10.1097/01.PSY.0000084835.46074.F0
[26] Themes, B., Meiser, B., & Hickie, I. B. (2001). Psychomemtric properties of the impact of event scale amongst women at increased risk for hereditary breast cancer. Psycho-Oncology, 10, 459-468. doi:10.1002/pon.533
[27] Tibben, A., Duivenvoorden, H. J., Niermeier, M. F., Vegter-Van Der Vlis, M., Roos, R. A. C., & Verhage, F. (1994). Psychological effects of presymptomatic DNA testing for Huntington’s disease in a Dutch program. Psychosomtric Medicine, 56, 526-532.

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.