Title:
Prevalence of posttraumatic stress disorder due to stroke: A meta-analysis
Objective:
To estimate the prevalence of stroke-induced posttraumatic stress disorder (PTSD) using systematic review and meta-analysis.
Methods:
Potentially relevant peer-reviewed journal articles were identified by searching the Ovid MEDLINE, PsycINFO, PILOTS Database, The Cochrane Library and Scopus from inception to April 2012; all searches were conducted on April 13, 2012. Observational cohort studies that assessed PTSD with specific reference to a stroke or TIA that occurred at least 1 month prior to the PTSD assessment were included. We abstracted PTSD rates and characteristics of the study and sample from all included studies. The coding of all articles included demographic information, sample size, study country, and method and timing of PTSD assessment.
Results:
Eight studies (N= 1,111) met our inclusion criteria. PTSD prevalence estimates varied significantly across studies by timing of PTSD assessment (ie., within 1 year of stroke vs greater than 1 year post-stroke; 70% of heterogeneity explained;
Q
1
=14.68;
P
<.001). The final aggregate prevalence estimate was 14% (95% CI, 11%-17%) from the random effects model comprised of an aggregate estimate of 25% (95% CI, 17%-35%) for PTSD within 1 year of stroke and 11% (95% CI, 8%-14%) after 1 year.
Conclusions:
Although posttraumatic stress disorder (PTSD) is commonly thought to be triggered by external events such as combat or sexual assault, these results suggest that as many as 1 in 4 stroke survivors develop significant PTSD symptoms due to the stroke. Further research is needed to determine whether stroke-induced PTSD increase recurrence risk in stroke patients.
Figure 1. Stroke-induced PTSD prevalence estimates
Note: The area of each square is proportional to the study’s weight in the meta-analysis, and each line represents the confidence interval around the estimate. Diamonds represent aggregate estimates, by PTSD assessment timing and overall.
Psychometric Performance of the Miller Forensic Assessment of Symptoms Test (M-FAST) in Veteran PTSD Assessment
