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One in four stroke survivors developed PTSD
Nearly one in four patients who survived a stroke or transient ischemic attack experienced symptoms of posttraumatic stress disorder within 1 year of the event, researchers reported in PLoS One.
“The experience of stroke or transient ischemic attack is traumatic for many survivors,” Donald Edmondson, PhD, of the Center for Behavioral Cardiovascular Health at Columbia University Medical Center, said in an interview. “Clinicians and caregivers should be aware of the potential for PTSD in stroke survivors.”
Donald Edmondson
In a meta-analysis of nine studies that included more than 1,100 stroke and transient ischemic attack (TIA) survivors, Edmondson and colleagues found that the estimated rate of PTSD within the first year was 23% (95% CI, 16-33). Approximately 11% (95% CI, 8-14) of stroke and TIA survivors experienced chronic PTSD symptoms lasting more than 1 year.
According to the researchers, approximately 85% of the 795,000 patients who experience a stroke in the United States each year survive at least 30 days, and about 500,000 patients develop a TIA. If the findings can be confirmed, this translates to 297,850 stroke and TIA survivors experiencing PTSD symptoms in the United States each year.
Edmondson and colleagues said a limitation of the study was the difference in PTSD prevalence reflected in studies that used clinical interviews vs. those that relied on self-reports.
The researchers said future research should focus on how PTSD affects certain health outcomes, as well as effective interventions for those with the disorder.
“Researchers should determine whether stroke-induced PTSD is associated with adverse cardiovascular prognosis, and which treatments are most effective for treating PTSD in stroke survivors,” Edmondson said.
Disclosure: The researchers report no relevant financial disclosures.
Perspective
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Neuropsychiatric disorders, including depression and anxiety, occur frequently after stroke and transient ischemic attack (TIA). This systematic review and meta-analysis of previous studies suggest that posttraumatic stress disorder is also common after stroke or TIA, similar to other significant illnesses. Other studies also suggest that stroke and TIA patients may be less adherent to prescribed medications than those without PTSD. Whether the presence of PTSD after stroke or TIA leads to a higher risk of subsequent cerebral or cardiovascular events and, if present, whether treatment reduces those risks is unknown. Physicians caring for patients after a cerebrovascular event should be aware that they are at risk for neuropsychiatric disorders and consider treatment options as may be appropriate.