Abstract
Background and PurposePosttraumatic stress disorder (PTSD) is common in survivors of acute life-threatening illness, but little is known about the burden of PTSD in survivors of stroke and transient ischemic attack (TIA). This study estimated the prevalence of stroke or TIA-induced posttraumatic stress disorder (PTSD) using systematic review and meta-analysis.MethodsPotentially relevant peer-reviewed journal articles were identified by searching the Ovid MEDLINE, PsycINFO, PILOTS Database, The Cochrane Library and Scopus from inception to January 2013; all searches were conducted on January 31, 2013. Observational cohort studies that assessed PTSD with specific reference to a stroke or TIA that occurred at least 1 month prior to the PTSD assessment were included. PTSD rates and characteristics of the study and sample were abstracted from all included studies. The coding of all articles included demographics, sample size, study country, and method and timing of PTSD assessment.ResultsNine studies (N = 1,138) met our inclusion criteria. PTSD rates varied significantly across studies by timing of PTSD assessment (i.e., within 1 year of stroke/TIA versus greater than 1 year post-stroke/TIA; 55% of heterogeneity explained; Q 1 = 10.30; P = .001). Using a random effects model, the estimated rate of PTSD following stroke or TIA was 23% (95% CI, 16%–33%) within 1 year of the stroke or TIA and 11% (95% CI, 8%–14%) after 1 year.ConclusionsAlthough PTSD is commonly thought to be triggered by external events such as combat or sexual assault, these results suggest that 1 in 4 stroke or TIA survivors develop significant PTSD symptoms due to the stroke or TIA. Screening for PTSD in a large population-based prospective cohort study with cardiovascular outcome assessments is needed to yield definitive prevalence, and determine whether stroke or TIA-induced PTSD is a risk factor for subsequent cardiovascular events or mortality.
Highlights
Posttraumatic stress disorder (PTSD) is an anxiety disorder initiated by exposure to a traumatic event and is characterized by symptoms of re-experiencing, avoidance of reminders of the event, persistent negative mood and cognition, and physiological hyperarousal that persist for at least 1 month after the event
A recent metaanalysis further suggests that PTSD triggered by cardiovascular events - acute coronary syndrome (ACS) - is associated with a doubling of risk for recurrent cardiac events and mortality [3] [4]
We evaluated the quality of each study based on the Methodological Evaluation of Observational Research (MORE)- Observational Studies of Incidence or Prevalence of Chronic Diseases developed by the Agency for Healthcare Research and Quality (AHRQ) [14]
Summary
Posttraumatic stress disorder (PTSD) is an anxiety disorder initiated by exposure to a traumatic event and is characterized by symptoms of re-experiencing, avoidance of reminders of the event, persistent negative mood and cognition, and physiological hyperarousal that persist for at least 1 month after the event. While the association between stroke or TIA-induced PTSD and risk for recurrent stroke or other cardiovascular events was not examined, participants in this study were nearly three times more likely than those without PTSD symptoms to report medication nonadherence [13]. These data suggest that, similar to ACS-induced PTSD, stroke or TIA-induced PTSD may increase risk for recurrent stroke and other cardiovascular events. This meta-analytic review of cross-sectional studies was designed to estimate the overall prevalence of PTSD due to stroke or TIA. This study estimated the prevalence of stroke or TIA-induced posttraumatic stress disorder (PTSD) using systematic review and meta-analysis
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
