Posttraumatic Stress Disorder Symptoms in Patients with acute myocardial infarction

Abstract

OBJECTIVE: The aim of this study is investigate depression,anxiety and post traumatic stres disorder PTSD symptoms in patients with acute myocardial infarction AMI . In our study psychiatric symptoms was also examined in relation with clinical findings.METHODS: In this study 50 patients who came to the cardiology policlinic after spending a month after AMI were taken. Sociodemographic form, Hospital Ankiyet-Depression HAD and Post Traumatic Stress Disorder Checklist Civilian Version PTSD-CL were asked to complete questionnaires. After AMI patients who expreriencing physical or mental events can lead PTSD symptoms were excluded from the study.RESULTS: The average score of the patients anxiety scale was 8.7±4.3. Anxiety scale, when evaluated according to the cut-off point, 26% of patients were shown to be of the anxiety disorder. Depression scale, the average score was 7.2 ± 3.6 and according to the cut off point scale depressive disorder could be detected.in 36% of patients n = 18 . PCL-C scale, the average score was 22.1 ± 5.1. 24% of patients had a value above according to the cut-off scores on the PCL-C scale and the possibility of PTSD was considered in these patients.CONCLUSION: In this study, AMI patients were identified with high rates of PTSD symptoms. The duration of hospitalization and angina symptoms after discharge were associated with symptoms of PTSD. In AMI patients PTSD symptoms as well as depressive symptoms must be considered.

Keywords

• PTSD,AMI,Anxiety

Akut Miyokard İnfarktüs Geçiren Hastalarda Travma Sonrası Stres Bozukluğu Belirtileri

Abstract

AMAÇ: Bu çalışmanın amacı akut miyokard infarktüs AMİ geçiren hastalarda depresyon, anksiyete ve travma sonrası stres bozukluğu TSSB belirtilerini araştırmaktır. Çalışmamızda ruhsal belirtilerin klinik bulgular ile ilişkisi de incelenmiştir.YÖNTEMLER: Bu çalışmaya AMİ geçirdikten bir ay sonra kardiyoloji polikliniğine kontrol amaçlı gelen 50 hasta alınmıştır. Hastalara sosyodemografik form, Hastane Ankiyete-Depresyon HAD ve Travma Sonrası Stres Bozukluğu Kontrol Listesi Sivil Sürümü PTSB-CL ölçekleri doldurtulmuştur. AMİ sonrası TSSB belirtilerine yol açabilecek bedensel, fiziksel veya ruhsal olay yaşayan hastalar çalışmaya alınmamıştır.BULGULAR: Hastaların anksiyete ölçeğinin ortalama puanı 8.7±4.3 olarak bulundu. Anksiyete ölçeğinin kesme puanına göre değerlendirme yapıldığında; hastaların % 26’sının anksiyete bozukluğu olabileceği gösterildi. Depresyon ölçeğinin ortalama puanı 7.2±3.6 idi ve ölçeğin kesme puanına göre hastaların % 36’sında n=18 depresif bozukluk olabileceği saptandı. PCL-C ölçeğinin ortalama puanı 22.1±5.1 idi. Hastaların % 24’ü PCL-C ölçeğine göre kesme puanının üzerinde bir değerdeydi ve bu hastalarda TSSB olasılığı düşünüldü.SONUÇ: Bu çalışmada AMİ geçiren hastalarda yüksek oranda TSSB belirtileri saptanmıştır. Hastanede yatış süresi ve taburculuk sonrası anjina şikayetleri TSSB belirtileri ile ilişkili bulunmuştur. AMİ geçiren hastalarda depresif bulguların yanı sıra TSSB belirtilerine de dikkat edilmesi gerektiğini düşünmekteyiz.

Keywords

• PTSB,AMI,Anksiyete

References

1. 1. Jing Fang M, Kate M. Shaw, MS, Nora L. Keenan, PhD. Prevalence of Coronary Heart Disease United States, 2006-2010. Div for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promo-tion. 2011.
2. 2. Shapiro PA. Cardiovascular disorders. BJ Sadock, VA Sa-dock (eds): Comprehensive Textbook of Psychiatry. Yedinci baskı, Philadelphia, Lippincott Wil-liams & Wilkins, 2000, s.1797-1803.
3. 3. Frasure-Smith N, Lesperance F, Talajic M. Depression following myocardial infarction. Impact on 6-month survi-val. JAMA: the journal of the American Medical Association. 1993; 270: 1819-25.
4. 4. Kivelä SL. How common are depressions and cardiovascular diseases in populations. In: Vascular Disease and Affective Disorders. Editors: Edmond Chiu, David Ames, Cornelius Catona. Martin Dunitz Ltd: London, UK, 2002.
5. 5. Moser DK, Riegel B, McKinley S. Impact of anxiety and perceived control on in-hospital complications after acute myocardial infarction. Psychosom Med 2007;69:10-6.
6. 6. De Jong MJ, Chung ML, Roser LP, Jensen LA. A five-country comparison of anxiety early after acute myocardial infarction. Eur J Cardiovasc Nurs 2004;3:129-34.
7. 7. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4. Baskı, Washington DC: American Psychiatric Press 2000; 429-85.
8. 8. Braunwald E, Zipes DP, Libby P (Editors). Heart Disease: A Textbook of Cardiovascular Medicine, 6th edition. W. B. Saunders Company, Philadelphia, Pennsylvania, 2001.

9. 9. Lesneski L, Morton P. Delay in seeking treatment for acute myocardial infarction: why? J Emerg Nurs 2000;26:125-9.
10. 10. Beach EK, Smith A, Luthringer L. Self-care limitations of persons after acute myocardial infarction. Appl Nurs Res. 1996;9:24-8.
11. 11. Worrall-Carter L, Jones T, Driscoll A. The experiences and adjustments of women following their first acute myocardial infarction. Contemp Nurse 2005;19:211-21.
12. 12. Moser DK, Dracup K. Is anxiety early after myocardial infarction associated with subsequent ischemic and arrhythmic events? Psychosom Med 1996;58:395-401.
13. 13. Strik JJ, Denollet J, Lousberg R. Comparing symptoms of depression and anxiety as predictors of cardiac events and increased health care consumption after myocardial infarction. J Am Coll Cardiol 2003;42:1801-7.
14. 14- Zigmund AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 1983; 67: 361-370.
15. 15- Aydemir Ö, Güvenir T, Küey L. Validity and realibility of Turkish version of Hospital Anxiety and Depression Scale. Turkish Journal of Psychiatry 1997; 8: 280-287.
16. 16. Dobbie DR, Kivlahan DR, Maynard C, Bush KR, McFall M, Epler AJ, Bradley KA. Screening for posttraumatic stress disorder in female veteran’s affairs patients: Validation of the PTSD checklist. Gen Hosp Psychiatry 2002; 24:367–374.
17. 17. Kocabaşoğlu N, Çorapçıoğlu Özdemir A, Yargıç İ, Geyran P. Türkçe “PTSD Checklist – Civilian Version” (PCL-C) Ölçeğinin geçerlilik ve güvenilirliği. Yeni Symposium 2005;43: 126-134.
18. 18. Raviele A, Giada F, Bergfeldt L, Blanc JJ, Blomstrom-Lundqvist C. Management of patients with palpitati-ons: a position paper from the European Heart Rhythm Association. Europace 2011; 13: 920934.
19. 19. Badır A (2009) Kalp hastalıklarına bağlı komplikasyonlar. Dahili ve cerrahi hastalıklarda bakım içinde, Karadakovan A, Eti Aslan F, Editörler. istanbul: Nobel Kitabevi, 559-560.
20. 20. Kuper H, Marmot M, Hemingway H (2002) Systematic review of prospective cohort studies of psychosocial factors in the aetiology and prognosis of coronary heart disease. Semin Vasc Med;2:267 314.
21. 21. Jiang W, Krishnan RR, O'Connor CM. Depression and heart disease: evidence of a link, and its therapeutic implications. CNS Drugs 2002;16:111- 27.
22. 22. Dias CC, Mateus PS, Mateus C. Acute coronary syndrome and depression. Rev Port Cardiol. 2005a;24:507-16.
23. 23. Huffman JC, Smith FA, Blais MA, Januzzi JL Fricchione GL (2008) Anxiety, independent of depressive symptoms, is associated with in-hospital cardiac complications after acute myocardial infarction. J Psychosom Res;65:557 -63.
24. 24. Edmondson D, Richardson S, Falzon L, Davidson KW, Mills MA, Neria Y. Posttraumatic stress disorder prevalence and risk of recurrence in acute coronary syndrome patients: a meta -analytic review. PLoS One. 2012;7(6):e38915.
25. 25. 42. Davidson J, Smith R (1990) Traumatic experiences in psychiatric outpatients. J Trauma Stress 3: 459 –475.
26. 26. Switzer GE, Dew MA, Thompson K, Goycoolea JM, Derricott T. (1999) Posttraumatic stress disorder and service utilization among urban mental health center clients. J Trauma Stress 12: 25 –39.
27. 27. Gander M -L, von Kanel R (2006) Myocardial infarction and post -traumatic stress disorder: frequency, outcome, and atherosclerotic mechanisms. Eur J Cardiovasc PrevRehabil 13: 165 – 172.
28. 28. Edmondson D, Shaffer JA, Denton EG, Shimbo D, Clemow L. Posttraumatic stress and myocardial infarction risk perceptions in hospitalized acute coronary syndrome patients. Front Psychol. 2012 May 14;3:144.
29. 29. Edmondson D, Rieckmann N, Shaffer JA, Schwartz JE, Burg MM, Davidson KW, Clemow L, Shimbo D, Kronish IM. Posttraumatic stress due to an acute coronary syndrome increases risk of 42 month major adverse cardiac events and all -cause mortality. J Psychiatr Res. 2011 Dec;45(12):1621 -6.
30. 30. Ayers S, Copland C, Dunmore E.A preliminary study of negative appraisals and dysfunctional coping associated with post -traumatic stress disorder symptoms following myocardial infarction. Br J Health Psychol. 2009 Sep;14(Pt 3):459 -71.
31. 31. Newman JD, Muntner P, Shimbo D, Davidson KW, Shaffer JA, Edmondson D. Post -traumatic stress disorder (PTSD) symptoms predict delay to hospital in patients with acute coronary syndrome. PLoS One. 2011;6(11):e27640.
32. 32. von Kanel R, Hepp U, Kraemer B, Traber R, Keel M, et al. (2007) Evidence for low -grade systemic proinflammatory activity in patients with posttraumatic stres disorder. J Psychiatr Res 41: 744 –752.
33. 33. Kubzansky LD, Koenen KC (2009) Is posttraumatic stress disorder related to development of heart disease? An update. Cleve Clin J Med 76 Suppl 2: S60 –65.
34. 34. Payne TJ, Johnson CA, Penzien DB, Porzelius J. Chest pain self -management training for patients with coronary artery disease. J Psychosom Res 1994;38:409 -18.
35. 35. Türkmen SN, Çam MO. Miyokart Enfarktüsü Geçirmiş Hastalarda Psikoeğitimin Psikososyal Uyum Üzerine Etkisinin Değerlendirilmesi. Journal of Psychiatric Nursing 2012;3(3):105 -115.