TIA May Increase Risk for Post-Traumatic Stress Disorder



A transient ischemic attack (TIA) may increase the risk of post-traumatic stress disorder (PTSD), according to a study published online ahead of print October 2 in Stroke.

“We found one in three TIA patients develops PTSD,” said Kathrin Utz, PhD, a postdoctoral researcher in the Department of Neurology, Friedrich-Alexander University 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 patients with TIA who had no prior history of stroke and reviewing participants’ answers to a series of questionnaires that evaluated their mental state, the researchers found that:

• About 30% of patients with TIA disclosed symptoms of PTSD.

• About 14% of all patients with TIA showed significantly reduced mental quality of life, and 6.5% had a reduced physical quality of life.

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

Even a brief neurologic disorder that in itself does not lead to a chronic disability can be just as traumatic as a traffic accident or natural disaster, according to the researchers. The way a patient normally responds to stressful situations may help determine his or her 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,” Dr. Utz said.

“It is not yet entirely clear why some people develop PTSD following a TIA, but others do not,” Dr. Utz continued. “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 psychologic problems following a TIA.”

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

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