After a life-threatening disease such as heart attack, TIA (transient ischemic attack) or stroke it is possible to develop a chronic PTSD (posttraumatic stress disorder). First of all, this work discussed the prevalence of chronic PTSD of heart attack, TIA and stroke patients at least three months after diagnosis. Furthermore, all risk factors that contributed to the development and maintenance of posttraumatic symptoms were considered. The subgroup-differences have then been explored in relation to PTSD prevalence, quality of life and coping strategies but also to anxiety and depression.
114 patients (54 heart attacks, 18 TIAs und 40 strokes) from three general physician practices were interviewed and psychometric self-assessment tools were used to determine the prevalence of chronic PTSD and psychosomatic comorbidity for the three study groups. On the one hand the relation to the variable’s anxiety, depression, quality of life, coping, dissociation was considered and on the other hand the influence of risk factors like age and gender.
The prevalence of chronic PTSD of patients with heart attack, TIA and stroke, respectively, was 23,2 %. The experience of a heart attack, a TIA or a stroke increases the risk of developing chronic PTSD and the associated depression, anxiety, maladaptive coping and reduced quality of life. The present study found that adaptive coping is positively related to mental quality of life and negatively related to anxiety and depression. By contrast, variables such as age, gender, marital status, number of children, level of education, duration of illness or maladaptive coping do not seem to play a role in any of the investigated patient populations. The severity of study diseases was not related to the development of PTSD, depression, anxiety or physical quality of life. Female und elderly patients had a lower health-related quality of life.
Physicians should have comprehensive knowledge of the frequency and risk factors of chronic PTSD in order to identify risk patients after a heart attack or TIA or stroke at an early stage. In this way it is possible to improve the prevention and the psychosomatic treatment success leading to a better mental health and quality of life.