Trajectory of posttraumatic stress disorder caused by myocardial infarction: a two-year follow-up study

Abbas, Chiara C; Schmid, Jean-paul; Guler, Erika; Wiedemar, Lina; Begré, Stefan; Saner, Hugo; Schnyder, Ulrich; von Känel, Roland (2009). Trajectory of posttraumatic stress disorder caused by myocardial infarction: a two-year follow-up study. International journal of psychiatry in medicine, 39(4), pp. 359-76. Farmingdale, NY: Baywood Pub. Co. 10.2190/PM.39.4.b

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OBJECTIVE: A substantial proportion of patients develop posttraumatic stress disorder (PTSD) following myocardial infarction (MI). Previous research on the trajectory over time of PTSD in post-MI patients is scant and refers to self-rated posttraumatic symptoms. The aim of this study was to investigate the longitudinal course of an interviewer-rated diagnosis of PTSD and PTSD symptom severity following MI. METHODS: Study participants were 40 patients (78% men, mean age 54 +/- 8 years) who were diagnosed with PTSD using the Clinician-administered PTSD Scale (CAPS) after an average of 5 +/- 4 months (range 2-16 months) following an index MI. After a mean follow-up of 26 +/- 6 months (range 12-36 months), 24 patients underwent a second diagnostic interview. RESULTS: Two-thirds of patients (n = 16) still qualified for a diagnosis of PTSD at follow-up. In all 24 patients, total PTSD symptoms (p = 0.001), re-experiencing symptoms (p < 0.001), avoidance symptoms (p = 0.015), and, with borderline significance, hyperarousal symptoms (p < 0.06) had all decreased over time. However, in the subgroup of the 16 patients who had retained PTSD diagnostic status at follow-up, symptoms of avoidance (p = 0.23) and of hyperarousal (p = 0.48) showed no longitudinal decline. Longer duration of follow-up was associated with a greater decrease in avoidance symptoms (p = 0.029) and, with borderline significance, in re-experiencing symptoms (p < 0.07) across all patients. CONCLUSION: Although PTSD symptomatology waned over time and in relation to longer follow-up, two-thirds of patients still qualified for a diagnosis of PTSD 2 years after the initial diagnosis. In post-MI patients, clinical PTSD is a considerably persistent condition.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology > Centre of Competence for Psychosomatic Medicine

UniBE Contributor:

Wiedemar, Lina; Begré, Stefan and von Känel, Roland

ISSN:

0091-2174

Publisher:

Baywood Pub. Co.

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 15:13

Last Modified:

04 May 2014 23:23

Publisher DOI:

10.2190/PM.39.4.b

PubMed ID:

20391858

Web of Science ID:

000275766500002

URI:

https://boris.unibe.ch/id/eprint/32403 (FactScience: 197561)

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