One in four people who survive a stroke or transient ischemic attack (TIA) suffer from symptoms of post-traumatic stress disorder (PTSD) within the first year after the event, according to a new study.
The study, led by researchers from Columbia University Medical Center, also found that one in nine patients experience chronic PTSD more than a year later.
The data suggest that each year nearly 300,000 stroke/TIA survivors will develop PTSD symptoms, the study noted.
The new research builds on recent findings from the same team of researchers that PTSD is common among heart attack survivors, contributing “to a doubled risk of a future cardiac event or of dying within one to three years,” according to first author Donald Edmondson, Ph.D., M.P.H., assistant professor of behavioral medicine.
“Our current results show that PTSD in stroke and TIA survivors may increase their risk for recurrent stroke and other cardiovascular events,” he said.
“Given that each event is life-threatening and that strokes/TIAs add hundreds of millions of dollars to annual health expenditures, these findings are important to both the long-term survival and health costs of these patient populations.”
“PTSD is not just a disorder of combat veterans and sexual assault survivors, but strongly affects survivors of stroke and other potentially traumatic acute cardiovascular events as well,” added Ian Kronish, M.D., M.P.H., assistant professor of medicine and the study’s senior author.
“Surviving a life-threatening health scare can have a debilitating psychological impact, and health care providers should make it a priority to screen for symptoms of depression, anxiety, and PTSD among these patient populations.”
Stroke is the fourth-leading cause of death and the top cause of disability in the United States. According to data from the American Stroke Association, nearly 795,000 Americans suffer a new or recurrent stroke each year, and up to an additional 500,000 suffer a TIA.
PTSD is an anxiety disorder initiated by exposure to a traumatic event. Common symptoms include nightmares, avoidance of reminders of the event, and elevated heart rate and blood pressure. Chronic PTSD is characterized by a duration of these symptoms for three months or longer.
Since only a few studies have assessed PTSD due to stroke, the research team performed a meta-analysis of clinical studies of stroke- or TIA-induced PTSD. The nine studies included a total of 1,138 stroke or TIA survivors.
The study found that 23 percent of the patients developed PTSD symptoms within the first year after their stroke or TIA, while 11 percent experienced chronic PTSD more than a year later.
“PTSD and other psychological disorders in stroke and TIA patients appear to be an underrecognized and undertreated problem,” noted Kronish.
“Fortunately, there are good treatments for PTSD,” added Edmondson. “But first, physicians and patients have to be aware that this is a problem. Family members can also help. We know that social support is a good protective factor against PTSD due to any type of traumatic event.”
Further research is needed to assess whether mental health treatment can reduce stroke- and TIA-induced PTSD symptoms, according to Edmondson. That treatment can “help these patients regain a feeling of normalcy and calm as soon as possible after their health scare,” he concluded.
The study was published in the online edition of PLOS ONE.