‘Mini-stroke’ may lead to post-traumatic stress disorder

American Heart Association Rapid Access Journal Report

October 02, 2014 Categories: Stroke News

Study Highlights

  • About 30 percent of transient ischemic attack or “mini-stroke” patients had symptoms of post-traumatic stress disorder (PTSD) in a new study.
  • Those with PTSD had more depression, anxiety and reduced mental and physical quality of life.
  • Patients overestimating their stroke risk and who don’t cope with their mini-stroke well are at higher risk to develop PTSD.

Embargoed until 3 p.m. CT/4 p.m. ET Thursday, October 2, 2014

DALLAS, October 2, 2014 — A “mini-stroke” may increase your risk of developing post-traumatic stress disorder (PTSD), according to new research in the American Heart Association journal Stroke.

Transient ischemic attack (TIA), like stroke, is caused by restricted blood supply to the brain. A TIA is temporary and often lasts less than five minutes, without causing permanent brain damage.

“We found one in three TIA patients develop PTSD,” said Kathrin Utz, Ph.D., a study author and post-doctoral researcher in the Department of Neurology at the University of Erlangen-Nuremberg in Germany.

“PTSD, which is perhaps better known as a problem found in survivors of war zones and natural disasters, can develop when a person experiences a frightening event that poses a serious threat.”

The study is the first to analyze whether a TIA and the knowledge of an increased risk for stroke can lead patients to develop psychiatric problems.

After examining data from 108 TIA patients with no prior history of stroke and reviewing participants’ answers to a series of questionnaires that evaluated their mental state, German and British researchers found:

  • About 30 percent of patients with TIA disclosed symptoms of PTSD.
  • About 14 percent of all TIA patients showed significantly reduced mental quality of life and 6.5 percent had reduced physical quality of life.
  • Those with PTSD showed higher signs of depression, anxiety and reduced quality of life.

Patients’ fear of having a stroke and poor coping behaviors after a TIA may be partially to blame for them developing PTSD.

“While their fear is partly justified, many patients may be overestimating their risk and increasing their chances of developing PTSD,” Utz said.

“When experienced together, the symptoms from TIA and depression pose a significant psychological burden on the affected patient; therefore, it comes as no surprise that we also found TIA patients with PTSD have a measurably lower sense of quality of life.”

Even a brief neurological disorder, which in itself doesn’t lead to a chronic disability, can be just as traumatic as an event like a traffic accident or natural disaster, researchers said. The way a patient normally responds to stressful situations may help determine their risk of developing PTSD after a TIA.

“Patients who use certain types of coping strategies, such as denying the problem, blaming themselves for any difficulties or turning to drugs for comfort, face a greater risk of developing PTSD after TIA,” Utz said.

 “It is not yet entirely clear why some people develop PTSD following a TIA, but others do not. However, what we do know at this stage is that younger patients and patients who in general find it difficult to cope with stress are more likely to develop psychological problems following a TIA.”

Utz suggests providing patients better risk counseling and more positive adaptive strategies to cope with TIA.

Lead author of the study is Ines C. Kiphuth, M.D. Co-authors are Adam J. Noble, Ph.D.; Martin Köhrmann, M.D.; and Thomas Schenk, Ph.D.

Author disclosures and funding information are on the manuscript.

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