title: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Bern University Hospital, Switzerland.
authors.forename: Chiara C
authors.initials: CC
authors.lastname: Abbas
authors.forename: Jean-paul
authors.initials: JP
authors.lastname: Schmid
authors.forename: Erika
authors.initials: E
authors.lastname: Guler
authors.forename: Lina
authors.initials: L
authors.lastname: Wiedemar
authors.forename: Stefan
authors.initials: S
authors.lastname: Begré
authors.forename: Hugo
authors.initials: H
authors.lastname: Saner
authors.forename: Ulrich
authors.initials: U
authors.lastname: Schnyder
authors.forename: Roland
authors.initials: R
authors.lastname: von Känel
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D013557:Switzerland