Post-traumatic stress disorder following myocardial infarction: Prevalence and risk factorsLe trouble de stress post-traumatique après un infarctus du myocarde : La prévalence et les facteurs de risque

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Background

Post-traumatic stress disorder (PTSD) is associated with negative impacts on physical health. Victims of a myocardial infarction (MI) who develop PTSD may be particularly affected by these impacts due to their cardiovascular vulnerability. Post-traumatic reactions in this population are not well known.

Objectives

To examine the prevalence of PTSD after MI and its risk factors, and to validate a prediction model for PTSD symptoms.

Methods

Patients hospitalized for MI (n = 477) were recruited in three hospitals. The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and questionnaires concerning PTSD symptoms and general measures were administered to patients during hospitalization and at one-month follow-up.

Results

Four per cent of the patients had PTSD and 12% had partial PTSD. The perception of a threat to life, the intensity of acute stress disorder and depression symptoms several days after the MI, a history of referral to a psychologist or psychiatrist, and female sex were risk factors for the intensity of PTSD symptoms in a sequential multiple regression analysis (R = 0.634). The prediction model was validated by applying the regression equation to 48 participants who were not included in the initial regression (R = 0.633).

Conclusions

The risk factors for development of PTSD symptoms identified in the present study could be used to facilitate the detection of patients at risk for developing PTSD symptoms so they can later be offered psychological interventions as needed.

Historique

Le trouble de stress post-traumatique (TSPT) a des conséquences négatives sur la santé physique. Les victimes d’un infarctus du myocarde (IM) qui ont un TSPT peuvent être particulièrement touchées en raison de leur vulnérabilité cardiovasculaire. Les réactions post-traumatiques au sein de ces populations sont mal connues.

Objectifs

Examiner la prévalence de TSPT après un IM et les facteurs de risque s’y rapportant, et valider un modèle prédictif des symptômes de TSPT.

Méthodologie

On a recruté des patients hospitalisés en raison d’un IM (n = 477) dans trois hôpitaux. Les patients ont répondu à l’entrevue clinique structurée du Manuel diagnostique et statistique des troubles mentaux, quatrième édition, et à des questionnaires sur les symptômes du TSPT et sur des mesures générales pendant leur hospitalisation et dans le cadre d’un suivi un mois plus tard.

Résultats

Quatre pour cent des patients avaient un TSPT et 12%, un TSPT partiel. Selon une analyse de régression multiple séquentielle, la perception d’une menace à la vie, l’intensité d’un trouble de stress aigu et des symptômes de dépression quelques jours après l’IM, des antécédents d’aiguillage vers un psychologue ou un psychiatre et le sexe féminin étaient des facteurs de risque liés à l’intensité des symptômes de TSPT (R = 0,634). Les chercheurs ont validé le modèle prédictif en appliquant l’équation de régression à 48 participants exclus de l’analyse de régression initiale (R = 0,633).

Conclusions

Les facteurs de risque de présenter les symptômes de TSPT repérés dans la présente étude pourraient servir à faciliter la détection des patients vulnérables à ces symptômes afin qu’on puisse leur offrir des interventions psychologiques, au besoin.

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