Post-traumatic stress disorder among heart disease patients: a clinical follow-up of individuals with myocardial infarction in the Tromsø Study

• Published in: BMC psychiatry Vol. 23; no. 1; p. 936
• Main Authors: Lorem, Geir Fagerjord, Næss, Eva T, Løchen, Maja-Lisa, Lillevoll, Kjersti, Molund, Else-Marie, Rösner, Assami, Lindkvist, Sigmund, Schirmer, Henrik
• Format: Journal Article
• Language: English
• Published: England BioMed Central 12.12.2023; BMC
• Subjects: Anxiety; Cardiovascular disease; Cohort analysis; Comorbidity; Diagnosis; Epidemiology; Heart attacks; Heart diseases; Hospitals; Mental depression; Mental disorders; Mental health; Mental trauma; Myocardial infarction; Post traumatic stress disorder; Post-traumatic stress disorder (PTSD); Questionnaires; Stressful life events; The Tromsø Study; Norway; Myocardial infarction; Post-traumatic stress disorder (PTSD); Mental health; Mental trauma; The Tromsø Study; Comorbid mental health; Public health; Stressful life events
• ISSN: 1471-244X; 1471-244X
• DOI: 10.1186/s12888-023-05431-2

Myocardial infarction is likely to be experienced as a life-threatening and potentially traumatic event. Approximately one-third of patients with myocardial infarction experience clinically significant symptoms of anxiety/depression. However, it is unclear how many of these patients experience these symptoms because of post-traumatic stress disorder (PTSD). We conducted a clinical screening of individuals with a confirmed myocardial infarction diagnosis. Our goal was to examine the prevalence of PTSD in myocardial infarction patients and study how PTSD symptoms were associated with exposure to potentially traumatic events. This is epidemiological research with a cross-sectional design following up participants from the Tromsø Study with a confirmed diagnosis of myocardial infarction. We sent invitations to participants in the Tromsø Study with clinically significant self-reported anxiety or depression symptoms following myocardial infarction. A cross-sectional sample of N = 79 participants (61 men and 18 women) was collected. During an interview, participants completed the Stressful Life Events Screening Questionnaire and the PTSD checklist PCL-5. We found nine participants (11.6%) with probable PTSD. This was significantly higher than the postulated population prevalence in Norway (p < 0.015). We found no direct association between myocardial infarction as illness trauma and symptom levels (p = 0.123). However, we found a significant linear trend (p = 0.002), indicating that symptom severity increased proportionately as the number of post-traumatic events increased. PTSD prevalence in myocardial infarction patients was related to lifetime exposure to traumatic events, not the myocardial infarction event alone. More research is required to examine the interaction between myocardial infarction and PTSD. Clinicians should be aware that anxiety or depression symptoms after MI could be secondary symptoms of PTSD.