Post–traumatic stress disorder in patients with coronary artery disease: A review and evaluation of the risk

Abstract

Psychosocial factors are known to impact on the prognosis of patients with coronary artery disease independently of disease severity. However, few studies have looked at whether these patients are at risk of developing post-traumatic stress disorder, and the potential implications for morbidity and mortality. Through a review of the empirical literature, the objectives were to investigate whether patients with coronary artery disease are at risk of developing this disorder, to look at relations between post-traumatic stress disorder and heart disease, and to stimulate further research. The review indicated that some patients with coronary artery disease are at risk of developing post-traumatic stress disorder, although the prevalence varied considerably. Methodological issues together with recommendations for future research are discussed. Although only some cardiac patients may develop post-traumatic stress, this disorder should not be overlooked due to its potential role in reinfarctions and mortality.

Posttraumatic stress disorder and general health problems following myocardial infarction (Post‐MI PTSD) among older patients: the role of personality

“…Willing to face it behaviourally, however, meant being reminded of it which, in turn, seemed to generate upsetting thoughts or images for about half of the patients. Such willingness to face it among these patients cast doubt on a recent hypothesis that MI patients, as part of their posttraumatic disturbance, tend to avoid being reminded of their MI (Alonzo and Reynolds, 1998;Pedersen, 2001;Shemesh et al, 2001Shemesh et al, , 2004.…”

A dynamic view of comorbid depression and generalized anxiety disorder symptom change in chronic heart failure: the discrete effects of cognitive behavioral therapy, exercise, and psychotropic medication

“…hospitalised CVD patients, and showed that 53% of GAD patients had this disorder for more than 1 year. Previously, Pedersen [62] questioned whether anxiety interventions were redundant in light of the immense funding, research and intervention efforts invested for depression among CVD populations. The paucity of prior anxiety studies by comparison to depression in CVDs suggests that further work is required to explicate potential gains in mental health, CVD related outcomes [63], and costeffectiveness by treating anxiety disorders.…”

The impact of mental illness on cardiac outcomes: A review for the cardiologist

“…Generalized anxiety disorder, a condition characterized by chronic worry and difficulty controlling worry, is associated with elevated rates of CVD risk factors, such as smoking, hypercholesterolemia and diabetes [66], and predicted major cardiac events in a 2-year follow-up of patients with coronary artery disease [67]. Similarly, post traumatic stress disorder can occur after a severe cardiac event [68], and is associated with increased risk for CVD [68,69]. Phobic anxiety, an agoraphobia-type fear, is a risk factor for cardiac mortality, particularly sudden cardiac death [70,71].…”