Title:Post-traumatic Stress Disorder in Heart Failure Patients: A Test of the Cardiac Disease-induced PTSD Hypothesis
Volume: 15
Issue: 4
Author(s): Phillip J. Tully*Suzanne M. Cosh
Affiliation:
- Freemasons Foundation Centre for Men’s Health, School of Medicine, The University of Adelaide, Adelaide,Australia
Keywords:
Post-traumatic stress disorder, depression, anxiety disorder, heart failure, cardiomyopathy, trauma.
Abstract: Background: Post-traumatic stress disorder (PTSD) is prevalent in approximately 12% of
patients with cardiovascular disease (CVD) and such patients are at risk of further CVD morbidity
and mortality. It is unknown whether CVD patients with cardiac and non-cardiac traumatic events
leading to PTSD differ in medical comorbidities and psychiatric vulnerabilities. Our objective was
to compare heart failure (HF) patients with cardiac and non-cardiac PTSD.
Methods: A population of HF patients from 3 hospitals underwent a two-step depression and anxiety
screening process to identify potential mental health treatment needs. The post-traumatic stress
disorder module of the Structured Clinical Interview for DSM-IV Axis-I disorders was used to classify
trauma(s) exposure, and other disorders. The patients with PTSD were sub-divided by cardiac
related traumas (e.g. myocardial infarction, sudden cardiac arrest) and non-cardiac related traumas
(e.g. sexual abuse, interpersonal violence).
Results: 10 patients met criteria for non-cardiac trauma and 18 patients met criteria for cardiacinduced
trauma. There were no significant differences in HF aetiology or severity nor cardiac comorbidities.
Time since PTSD, onset was significantly longer for those with non-cardiac PTSD.
Among psychiatric comorbidities, alcohol and substance abuse disorders, as well as depression were
more prevalent in patients with non-cardiac PTSD.
Conclusion: Cardiac related PTSD was associated with less alcohol and substance abuse disorders,
and depression by comparison to their non-cardiac induced PTSD counterparts. Ongoing research is
required to establish if cardiac-induced PTSD truly reflects a unique subtype of PTSD, and whether
there are different treatment needs and therapeutic approaches for this subtype.
