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Child's surgery puts mom at risk for PTSD. (Bone Marrow Transplants).

BALTIMORE -- The mothers of children who undergo bone marrow transplant are at increased risk for at least some of the symptoms of posttraumatic stress disorder, Sharon L. Manne, Ph.D., said at the annual meeting of the International Society for Traumatic Stress Studies.

Unfortunately, there is no way to predict which ones are at risk for the symptoms associated with an extreme reaction to stress, she said, reporting on data from her longitudinal study of maternal distress. The study was funded by the National Institutes of Health.

Bone marrow transplants can save lives, but the procedure is "universally" stressful for parents who are already stressed by their child's potentially fatal illness, said Dr. Manne, director, psychooncology program, Fox Chase Cancer Center, Philadelphia. Bone marrow transplant is associated with a 40%-50% 1-year mortality as well as significant short- and long-term morbidity.

She reported on preliminary findings from an ongoing study of 280 mothers of children who underwent a bone marrow transplant for either treatment of high-risk leukemia or relapsing leukemia. The incidence of posttraumatic stress disorder (PTSD) in mothers of children who survived both the procedure and the disease was assessed at 6 and 18 months post transplantation using the Structured Clinical Interview for DSM-IV.

Of the 280 mothers enrolled in the study; 126 completed the interview at 6 months and 69 completed the interview at 18 months. Between the time of the bone marrow transplant and the 6-month interview, 48 children died and 29 mothers dropped out; between the 6- and 18-month interviews, 73 children died and 30 mothers dropped out, said Dr. Manne.

At 6 months, 14 mothers (11.1%) met the DSM-IV criteria for PTSD. At 18 months, 3 mothers (4%) had full-blown PTSD.

Significantly more mothers had a subclinical form of PTSD in which two of the three symptom clusters of intrusion, avoidance, and hyperarousal were present. Subclinical PTSD was present at 6 months in 28 mothers (22.2%) and at 18 months in 13 mothers (18.8%).

The most common symptoms in the subclinical syndrome at 6 months were those of hyperarousal, such as difficulty sleeping, irritability or outbursts of anger, impaired concentration, hypervigilance, and exaggerated startle response.

By 18 months, the most common symptoms were those of intrusion, such as recurrent, intrusive recollections of the event, distressing dreams, feeling the event was recurring, and distress at exposure to cues associated with bone marrow transplant.
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Article Details
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Author:Kubetin, Sally Koch
Publication:Clinical Psychiatry News
Geographic Code:1USA
Date:Jun 1, 2003
Words:400
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