Chronic Post-traumatic Stress Following a Myocardial Infarction: Prevalence and Detection in Hospital Setting

Christophe Fortin, Gilles Dupu

Abstract

Objective: This paper examines the prevalence of chronic Post-Traumatic Stress Disorder (PTSD) after a Myocardial Infarction (MI) and the factors associated its early detection in a hospital setting. Methods: Of 1344 MI patients admitted to three Canadian hospitals, 474 patients did not meet the inclusion criteria and 370 declined participation in the study; 500 patients consented to participate in the study. A structured clinical interview and questionnaires were administered to patients 48 hours to 14 days post-MI (M=4SD=2.7 days) and three months later to assess the prevalence of chronic PTSD and its risk factors. Results: Respectively 4.4% and 11.1% of the patients met the full and partial diagnostic criteria of chronic PTSD, measured with the Interview from the DSM-IV-TR PTSD module. Using binary logistic regression, both the intensity of anxiety (Beck Anxiety Inventory) (OR=1.05 per unit increase; p<.05, 95% CI: 1.00-1.10) and acute stress disorder symptoms (Modified PTSD Symptom Scale) (OR=1.05 per unit increase; p<.001, 95% CI=1.03-1.08), measured while in-hospital were associated with the presence of symptoms of PTSD three-months after the MI. Conclusion: Systematic in-hospital investigation of easily assessable risk factors is recommended in order to improve the detection of chronic PTSD and to prevent its detrimental effects on cardiovascular health.

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