title: Correlates of post-traumatic stress disorder in stroke survivors.
abstract: BACKGROUND
  Post-traumatic stress disorder (PTSD) can occur after life-threatening events, including illness, but correlates of PTSD after stroke or transient ischemic attack (TIA) have not been well described.
  
  
  METHODS
  We measured the prevalence of stroke-induced PTSD with the PTSD Checklist Specific for stroke (PCL-S) in adults who had a stroke or TIA within 5 years. A PCL-S score of 50 or more indicated likely PTSD. We tested for potential predictors of stroke-associated PTSD, including demographics, stroke history, disability, medical comorbidities, depression, and emotional support and then examined the association between poststroke PTSD and measures of physical and mental health.
  
  
  RESULTS
  Of 535 participants, 95 (18%) had a PCL-S score of 50 or more; the mean score was 35.4 ± 13.7 (range 17-80 of 85). In logistic regression analysis, low income (odds ratio [OR] 1.98, 95% confidence interval [CI] 1.01-3.61), recurrent stroke or TIA (OR 1.86, 1.10-3.16), more disability (OR 1.79, 1.43-2.23), and increased comorbidities (OR 1.90, 1.05-3.45) were independently associated with PTSD. Older age (OR .93, .90-.95), marriage or partnership (OR .52, .28-.98), and having emotional support (OR .25, .11-.54) were protective against developing PTSD. Participants with likely PTSD had worse physical and mental health.
  
  
  CONCLUSIONS
  In this racially and ethnically diverse cohort of stroke and TIA survivors, stroke-induced PTSD was associated with younger age, recurrent strokes, greater disability, and comorbidities. PTSD was associated with a substantially increased physical, mental, and quality of life burden in this already vulnerable population. Having social support was protective, suggesting a potential target for intervention.
authors.affiliation: Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai School of Medicine, New York, New York. Electronic address: judith.goldfinger@mountsinai.org.
authors.forename: Judith Z
authors.initials: JZ
authors.lastname: Goldfinger
authors.affiliation: Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, New York.
authors.forename: Donald
authors.initials: D
authors.lastname: Edmondson
authors.affiliation: Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, New York.
authors.forename: Ian M
authors.initials: IM
authors.lastname: Kronish
authors.affiliation: Department of Health Evidence and Policy, Mount Sinai School of Medicine, New York, New York.
authors.forename: Kezhen
authors.initials: K
authors.lastname: Fei
authors.affiliation: Division of Cardiology, New York University Langone Medical Center, New York, New York.
authors.forename: Revathi
authors.initials: R
authors.lastname: Balakrishnan
authors.affiliation: Department of Neurology, Mount Sinai School of Medicine, New York, New York.
authors.forename: Stanley
authors.initials: S
authors.lastname: Tuhrim
authors.affiliation: Department of Health Evidence and Policy, Mount Sinai School of Medicine, New York, New York.
authors.forename: Carol R
authors.initials: CR
authors.lastname: Horowitz
mesh_terms: D000368:Aged; D057189:Checklist; D016009:Chi-Square Distribution; D015897:Comorbidity; D004185:Disability Evaluation; D005260:Female; D006304:Health Status; D006801:Humans; D007182:Income; D002546:Ischemic Attack, Transient / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D016015:Logistic Models; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D016017:Odds Ratio; D015995:Prevalence; D011788:Quality of Life; D012008:Recurrence; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D013997:Time Factors
keywords: Stroke; modified Rankin score; post-traumatic stress disorder; quality of life; transient ischemic attack