One in every four survivors of stroke or TIA (transient ischemic attack) develops PTSD (post-traumatic stress disorder) within twelve months, while 1 in 9 has chronic PTSD for longer than a 12 months, researchers from Columbia University Medical Center reported in the journal PLoS ONE.

This means that almost 300,000 survivors of stroke or TIA develop PTSD symptoms each year in the USA as a result of their traumatic experience.

What is the difference between stroke and TIA? – a stroke occurs when brain cells suddenly die because of a lack of oxygen. This may be caused by an obstruction in the blood flow or the rupture of an artery that feeds the brain. In TIA the blockage is temporary. TIA symptoms occur rapidly and last a short time, usually less than five minutes. When a TIA is over there is usually no long-term injury to the brain.

First author Donald Edmondson, PhD, MPH, said:

“This work builds on recent findings of ours that PTSD is common among heart attack survivors and that it contributes to a doubled risk of a future cardiac event or of dying within one to three years.

Our current results show that PTSD in stroke and TIA survivors may increase their risk for recurrent stroke and other cardiovascular events. Given that each event is life-threatening and that strokes/TIAs add hundreds of millions of dollars to annual health expenditures, these findings are important to both the long-term survival and health costs of these patient populations.”

Senior author, Ian M. Kronish, MD, MPH, explained that PTSD does not just affect soldiers in action and survivors of sexual assaults. It can seriously affect stroke survivors, as well as other potentially traumatic acute cardiovascular events.

Dr. Kronish added “Surviving a life-threatening health scare can have a debilitating psychological impact, and health care providers should make it a priority to screen for symptoms of depression, anxiety, and PTSD among these patient populations.”

Stroke is the number one cause of disability in America. It is also the fourth-leading cause of death. The American Stroke Association estimates that annually almost 795,000 people in the country suffer a new or recurrent stroke and about 500,000 suffer a TIA.

PTSD is a fairly common anxiety disorder that develops after the patient was exposed to a terrifying event or ordeal in which serious physical harm occurred or threatened to occur. The patient’s family members are also at risk of developing the disorder.

Signs and symptoms of PTSD include:

  • Nightmares
  • Avoiding reminders of the event
  • Flashbacks – reliving the traumatic event
  • Accelerated heart rate
  • Being easily startled, feeling on edge
  • Sleeping difficulties
  • Elevated blood pressure

As only a few studies have looked at PTSD caused by stroke, the researchers conducted the first meta-analysis of clinical studies of PTSD due to stroke/TIA. They gathered and examined data from nine studies involving 1,138 patients who had survived a stroke/TIA.

They found that:

  • 23% of surviving patients developed PTSD symptoms within 12 months of their stroke or TIA
  • 11% went on to experience chronic (long-term) PTSD

Dr. Kronish said:

“PTSD and other psychological disorders in stroke and TIA patients appear to be an under-recognized and undertreated problem.”

There are effective therapies for treating PTSD, Dr. Edmondson explained. “But first, physicians and patients have to be aware that this is a problem. Family members can also help. We know that social support is a good protective factor against PTSD due to any type of traumatic event.”

The authors wrote:

“The next step is further research to assess whether mental health treatment can reduce stroke- and TIA-induced PTSD symptoms and help these patients regain a feeling of normalcy and calm as soon as possible after their health scare.”

Researchers from the University of Southern California in Los Angeles explained at the American Stroke Association’s International Stroke Conference 2013 that nearly 1 in every 12 stroke survivors in the USA may have thought of suicide or wished themselves dead.

Lead author, Amytis Towfighi, M.D., said that the percentage of stroke survivors who thought about suicide was “striking”.

Dr. Towfighi said “Given the high prevalence of suicidal thoughts among stroke survivors, perhaps regular screening for suicidal ideation, in addition to depression, is warranted.”

Another study found that one third of veterans recovering from stroke have depressive symptoms.

Written by Christian Nordqvist