Associations of fear of recurrence and social support with post-traumatic stress disorder and disease recurrence in patients with severe acute pancreatitis: a retrospective study.

OBJECTIVE: To explore the correlations among fear of recurrence, post-traumatic stress disorder (PTSD), social support and disease recurrence in patients discharged after severe acute pancreatitis (SAP), so as to provide evidence for psychological intervention and recurrence prevention in SAP survivors.

METHODS: A total of 855 adult inpatients newly diagnosed with SAP at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine from January 2020 to April 2025 were retrospectively enrolled. Baseline clinical data and 12-month post-discharge follow-up data including SAP recurrence events and psychological scale scores were collected. Intergroup comparison, correlation analysis, multivariate Logistic regression, linear regression and mediating effect model analyses were performed for statistical analysis.

RESULTS: The patients were divided into the recurrence group (144 cases) and non-recurrence group (711 cases). Baseline demographic characteristics, past medical history, etiology and disease severity were comparable between the two groups, except that the recurrence group had a significantly higher ICU admission rate (p = 0.026). The recurrence group presented significantly higher Fear of Progression Questionnaire-Short Form (FoP-Q-SF) and PTSD self-rating scale (PTSD-SS) scores, higher PTSD prevalence and severity, and lower Perceived Social Support Scale (PSSS) scores and proportion of high social support (all p < 0.001). Fear of recurrence was positively correlated with PTSD-SS scores (ρ = 0.64, p < 0.001). Multivariate regression analysis confirmed that fear of disease recurrence was positively associated with post-traumatic stress disorder (PTSD), while higher levels of social support were negatively associated with PTSD. PTSD-SS scores were positively associated with acute pancreatitis recurrence. Mediating effect analysis showed that PTSD had no significant mediating effect between social support and recurrence, nor between fear of recurrence and recurrence (all p > 0.05).

CONCLUSION: Fear of recurrence is positively associated with PTSD symptoms in SAP patients, while high social support is negatively associated with this adverse psychological impact via a buffering interaction effect. PTSD severity is independently associated with an increased risk of SAP recurrence. These findings highlight the importance of psychological assessment and social support interventions in the long-term management of SAP survivors.