Open AccessClinical Diagnosis of Posttraumatic Stress Disorder After Myocardial Infarction
Author(s) -
Guler Erika,
Schmid JeanPaul,
Wiedemar Lina,
Saner Hugo,
Schnyder Ulrich,
Känel Roland von
Publication year - 2009
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.20384
Subject(s) - medicine , learned helplessness , myocardial infarction , posttraumatic stress , feeling , psychiatry , clinical psychology , psychology , social psychology
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. Copyright © 2009 Wiley Periodicals, Inc.