Trajectory of Posttraumatic Stress Disorder Caused by Myocardial Infarction: A Two-Year Follow-up Study

Abstract

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.

Association Between Posttraumatic Stress Disorder Following Myocardial Infarction and Liver Enzyme Levels: A Prospective Study

“…Posttraumatic stress symptoms profoundly impact daily functioning and may persist for many years [11]. Of the 24 post-MI patients with DSM-IV PTSD also investigated in the present study, two-thirds still endorsed diagnostic PTSD, on average, 2 years later [18].…”

“…All participants provided written informed consent. The recruitment procedure has previously been detailed with regard to the identification of the 24 patients with PTSD following an index MI investigated in the present study [16,18]. In brief, all patients had been referred to the Department of Cardiology, University of Bern, Switzerland, with a verified ST elevation or non-ST elevation MI according to previous guidelines [19] and had left ventricular ejection fraction (LVEF) determined during coronary angiography.…”

Early Psychological Counseling for the Prevention of Posttraumatic Stress Induced by Acute Coronary Syndrome: The MI-SPRINT Randomized Controlled Trial

“…That only 1 patient developed clinical PTSD in our RCT is highly important in preventive terms, as PTSD, including ACS-induced PTSD, is a chronic disorder with little spontaneous remission [32]. In individuals diagnosed with acute stress disorder or PTSD [33], including ACS-induced PTSD [34], multiple-session trauma-focused cognitive behavioral therapy offered within a few months after a trauma is recommended to reduce traumatic stress symptoms.…”

Inflammatory Biomarkers in Patients with Posttraumatic Stress Disorder Caused by Myocardial Infarction and the Role of Depressive Symptoms

“…PTSD di-agnosis at study entry). After a mean follow-up of 32 months (range 18-44), 24 of the 40 patients with PTSD at study entry and 24 patients with no PTSD at study entry volunteered to participate in a follow-up investigation [37] . Of these, we report here data of 22 patients with post-MI PTSD and of 22 patients with no post-MI PTSD, as detailed below.…”