Trajectories of Posttraumatic Stress Disorder Following Myocardial Infarction: A Prospective Study
J Clin Psychiatry 2003;64:1217-1223
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: This study examines the trajectories
of posttraumatic stress disorder (PTSD) following myocardial
infarction (MI). More specifically, it has 2 aims: (1) to examine
whether the trajectory of PTSD is predicted by level of threat
and the nature of initial reactions and (2) to examine the
associations between the trajectory of PTSD and anxiety,
somatization, health-related quality of life, and hospitalization
7 months following MI.
Method: 116 MI patients were examined twice. At
time 1, within a week of the patient's MI, acute stress disorder
(ASD) was assessed and medical measures were obtained from
patients' hospital records. At time 2, 7 months later, PTSD,
anxiety, physical residuals, and health-related quality of life
were assessed. Data were gathered in 1999.
Results: Six percent of the respondents had both
ASD and PTSD, 10% did not have ASD but did have PTSD, and 12% had
ASD but not PTSD. The trajectory of PTSD was associated with
severity of anxiety, somatic complaints, and health-related
quality of life. In addition, while the severity of MI did not
predict the trajectory of PTSD, the perceived severity did.
Patients without PTSD but with prior ASD did not differ in their
initial reactions from those without ASD.
Conclusion: These findings provide support for
the considerable variability in the trajectory of the development
of PTSD and suggest that although ASD is associated with
subsequent PTSD, the predictive role of initial reactions is