Prevalence and predictors of posttraumatic stress disorder in patients with acute myocardial infarction

Wiedemar, Lina; Schmid, Jean‐Paul; Müller, Julia; Wittmann, Lutz; Schnyder, Ulrich; Saner, Hugo; Känel, Roland von

doi:10.1016/j.hrtlng.2007.03.005

Cited by 70 publications

(75 citation statements)

References 45 publications

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“…21 -23 We did not find that perceived pain predicted PTSD status, contrasting with previous studies in which pain scores did predict self-rated PTSD symptom levels. 12,22 We interpret that our study provides little evidence for the assumption that certain demographic, medical, and psychological factors differentiate clinical PTSD status from elevated PTSD symptom levels. This might be expected because posttraumatic stress occurs on a continuum of severity.…”

Section: Discussionmentioning

confidence: 67%

“…Although we recently diagnosed 9.4% of patients with DSM-IV PTSD in the first 190 post-MI patients screened and enrolled in the current protocol, 12 this prevalence was largely maintained when doubling the sample. This finding speaks for the robustness of the observation that about 10% of patients develop PTSD in the aftermath of an acute MI.…”

Section: Discussionmentioning

confidence: 86%

“…We approached 951 patients by mail who had previously been referred to the Cardiology Department of the Bern University Hospital, Switzerland, with a verified ST-segment elevation myocardial infarction (STEMI) or non-ST-segment elevation myocardial infarction (NSTEMI) as per previously published guidelines. 12,13 All included patients had undergone percutaneous transluminal coronary angioplasty at admission. Patients were excluded if they did not speak German or lived too far away from the University Hospital (>90 min by car or train).…”

Section: Study Design and Participantsmentioning

confidence: 99%

“…9 -11 Using a structured clinical interview, we recently diagnosed 9.4% of 190 patients with DSM-IV PTSD related to their MI. 12 Because of its limited sample size, that study did not allow us to reliably probe for predictors of a clinical PTSD diagnosis.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, we continued enrollment of post-MI patients in our previously described protocol, 12 thereby roughly doubling the sample size. We predicted a prevalence of clinical PTSD of about 10%.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Diagnosis of Posttraumatic Stress Disorder After Myocardial Infarction

Guler¹,

Schmid

Wiedemar

et al. 2009

Clinical Cardiology

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Background: Clinician-rated large-scale studies estimating the prevalence of posttraumatic stress disorder (PTSD) related to myocardial infarction (MI) and identifying predictors of clinical PTSD are currently lacking. Hypotheses: We hypothesized that PTSD is prevalent in post-MI patients and that the subjective experience of the MI determines PTSD status. Methods: We approached 951 post-MI patients with a questionnaire screening for PTSD symptoms related to their MI. Those responding and meeting a cutoff of PTSD symptom levels were invited to participate in a structured clinical interview to diagnose PTSD following Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. Fear of dying, feelings of helplessness, and severity of pain perceived during the MI were also assessed by visual analog scales. Results: The screening questionnaire was completed by 394 patients, whereby 77 met the cutoff for the interview (8 patients declined the interview). Forty of 394 patients (10.2%) had clinical PTSD (subsyndromal and syndromal forms combined). Younger age (OR 0.95, 95% CI 0.91-0.99), greater fear of dying (OR 2.77, 95% CI 1.28-5.97), and more intense feelings of helplessness (OR 2.97, 95% CI 1.42-6.21) were independent predictors of PTSD status. Perceived pain intensity during MI, sex, type of index MI, left ventricular ejection fraction, number of coronary occlusions, and highest level of total creatinine kinase were not significant predictors. Conclusions: Clinical PTSD is prevalent in post-MI patients. Demographic and particularly psychological variables related to the subjective experience of the event were stronger predictors of PTSD status than were objective measures of MI severity.

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 86%

Section: Study Design and Participantsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Clinical Diagnosis of Posttraumatic Stress Disorder After Myocardial Infarction

Guler¹,

Schmid

Wiedemar

et al. 2009

Clinical Cardiology

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Family Matters: Research and Clinical Management of Psychosocial Issues for ICD Patients and their Partners

Sears¹,

Kirian²,

Matchett³

et al. 2011

Cardiac Arrhythmia Management

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The success of the implantable cardioverter defi brillator (ICD) in several large -scale randomized trials has established the ICD as the treatment of choice in detecting and treating ventricular arrhythmias (AVID Investigators 1997 ;Moss et al. 2002 ;Bardy et al. 2005 ). Patientreported outcomes encompassing psychosocial and quality of life (QOL) outcomes have generally been positive and desirable. Nonetheless, living successfully with the risk of spontaneous, potentially life -threatening arrhythmias and the resulting, life -saving high -energy shocks presents challenges to a sizable minority of patients and their families. ICDs save lives in at -risk patients, but the ongoing need for comprehensive, biopsychosocial care plans addressing the range of issues for both patients and families has been a challenge in electrophysiology clinics. Researchers have been stimulated by this modern -day scenario to describe, predict, and treat the potential for general psychological distress (i.e., anxiety and depression) and avoidance behaviors in ICD patients. More recent research has added the perspective of ICD family members, such as partners/spouses/ signifi cant others, to better understand the collective adjustment challenges. Preliminary fi ndings indicate that this may be particularly needed as ICD spouses experience signifi cant distress as well. The purpose of this chapter is to review the overall psychosocial and QOL impact of ICDs on patients and their partners. Clinical management strategies and approaches will also be discussed.

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Interaction between catechol‐O‐methyltransferase polymorphism and childhood trauma in suicidal ideation of patients with post‐traumatic stress disorder

et al. 2020

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Introduction Suicidal behavior of post‐traumatic stress disorder (PTSD) patients is influenced by genetic and environmental factors. The catechol‐O‐methyltransferase ( COMT ) gene has been known to be associated with suicidal ideation. The present study aimed to explore the relationship of COMT polymorphism, childhood trauma, and suicidal ideation in patients with PTSD. Methods Fifty patients with PTSD and 62 healthy controls (HCs) were recruited, and COMT variants rs4680 and rs4633 were genotyped through peripheral blood. Psychological assessments such as the childhood trauma questionnaire (CTQ), the scale for suicidal ideation, the clinician‐administered PTSD scale for DSM‐5, and a PTSD checklist were administered. A regression analysis, the Johnson–Neyman technique, and a two‐way analysis of covariance were conducted. Results Interaction of COMT polymorphism (rs4680, rs4633) and childhood emotional abuse (subscale of CTQ) predicted suicidal ideation in patients with PTSD. Patients with the rs4680 Val/Val genotype, compared to Met carriers genotype, showed higher suicidal ideation when childhood emotional abuse was high. Patients with the rs4633 CC genotype, compared to T carriers genotype, showed higher suicidal ideation when childhood emotional abuse was high. Conclusion Our results suggest that vulnerability to suicide could be increased in the Val/Val genotype of COMT rs4680 and the CC genotype of rs4633 in patients with PTSD. Moreover, PTSD group with high childhood emotional abuse demonstrated a significantly higher suicidal ideation than did those with low childhood emotional abuse.

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Prevalence and predictors of posttraumatic stress disorder in patients with acute myocardial infarction

Cited by 70 publications

References 45 publications

Clinical Diagnosis of Posttraumatic Stress Disorder After Myocardial Infarction

Clinical Diagnosis of Posttraumatic Stress Disorder After Myocardial Infarction

Family Matters: Research and Clinical Management of Psychosocial Issues for ICD Patients and their Partners

Interaction between catechol‐O‐methyltransferase polymorphism and childhood trauma in suicidal ideation of patients with post‐traumatic stress disorder

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