Online Program

Prior stroke predicts posttraumatic stress disorder (PTSD) in a multi-ethnic cohort of stroke survivors: Evidence from the Discharge Educational Strategies for Reduction of Vascular Events (DESERVE) trial

Wednesday, November 4, 2015

Emily Goldmann, PhD, MPH, Division of Social Epidemiology, New York University College of Global Public Health, NY, NY
Eric T. Roberts, MPH, New York University Global Institute of Public Health, New York, NY
Veronica Torrico, MA, Global Institute of Public Health, New York University, New York, NY
Nina Parikh, MPH, PhD, Division of Social Epidemiology, New York University Global Institute of Public Health, NY, NY
Heather Carman Kuczynski, MPH, CHES, CPH, Global Institute of Public Health, New York University,, NY, NY
Bernadette Boden-Albala, DrPH, MPH, Division of Social Epidemiology, College of Global Public Health, New York University, New York, NY
Poststroke PTSD is associated with reduced quality of life and poor medication adherence in stroke survivors. Although prior traumatic events have been linked to elevated PTSD risk from a subsequent event, no study has examined whether prior stroke experience increases PTSD risk following a subsequent stroke.

Data come from DESERVE, a randomized controlled trial of mild stroke/transient ischemic attack (TIA) patients prospectively enrolled in a behavioral intervention to reduce vascular risk. Symptoms of partial or full PTSD related to the index stroke/TIA were assessed for 241 patients at six month follow-up using the PTSD Checklist. PTSD was defined as meeting DSM-IV criterion B and either criterion C or D. Chi-square tests and logistic regression were used to examine the association between prior stroke/TIA experience and PTSD related to the index stroke. Regression models were adjusted for age, race/ethnicity and disability at discharge.

Almost one-third (32.7%) of patients experienced a prior stroke/TIA. The prevalence of PTSD six months after discharge was 9.4% and was significantly higher among those with a prior stroke/TIA compared with those without (17.3% vs. 5.6%, p=0.02). Patients with prior stroke/TIA had 5.5 times greater odds of developing PTSD from the index stroke compared with those without (95% CI: 1.2-25.1).

Given the substantial proportion of stroke survivors who experience a recurrent stroke and the negative mental health consequences highlighted in this study, interventions that focus on prevention are critical for promoting mental and physical well-being in stroke survivors.

Learning Areas:


Learning Objectives:
Describe the prevalence of posttraumatic stress disorder after stroke in a racially and ethnically diverse population of stroke survivors Compare the odds of developing PTSD after stroke between individuals with and without previous stroke experience

Keyword(s): Strokes, Mental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an early career faculty member at New York University, working in the Division of Social Epidemiology on several stroke epidemiology research projects. Over the past several years, I have conducted research in the field of mental health, much of which focuses on posttraumatic stress disorder and mental health conditions following disasters.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.