Heart attack patients, and most likely those with other forms of heartdisease, run an increased risk of developing post-traumatic stressdisorder, says a new research review done in Denmark and theNetherlands.
This may lead to a vicious cycle, with the PTSD associated withheart disease harming the patient's future cardiac heath, according tothe study in the current issue of Psychosomatic Medicine.
Among heart attack patients, about 15 percent develop thepsychiatric disorder, according to review authors Helle Spindler of theUniversity of Aarhus, Denmark, and Susanne S. Pedersen, of TilburgUniversity, the Netherlands.
"PTSD has been shown to lead to impairments in socialfunctioning, vitality, physical health and health status; increasedpsychological distress and adverse prognosis," write the researchers.Also, preliminary findings suggest that PTSD may heighten the risk ofnoncompliance with treatment.
The authors reviewed 25 studies conducted since 1980 thatlooked at PTSD after one of the following cardiac events: myocardialinfarction (heart attack), sudden cardiac arrest, cardiac surgery,heart transplantation or congestive heart failure. The studies reportedeither an absolute number of PTSD cases among the patients or aprevalence rate -- how often the condition occurred within a largergroup -- for PTSD.
Among the 25 studies reviewed, the prevalence of PTSD afterheart disease ranged from zero to 38 percent. However, the researchersnote that some of the studies are based on very small numbers ofpatients; populations studied ranged from 23 patients to 2,325patients. The authors found that PTSD has been most rigorously studiedin relation to heart attack and that the best studies showed a 15percent prevalence rate for PTSD in these patients.
Coronary artery disease remains the leading cause of death in the Western world despite being highly treatable.
The authors identified six groups of risk factors increasing the likelihood of PTSD in CAD patients:
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