Medications as Traumatic Reminders in Patients With Stroke/Transient Ischemic Attack-Induced Posttraumatic Stress Disorder

Nadia Liyanage-Don, Jeffrey Birk, Talea Cornelius, Gabriel Sanchez, Nathalie Moise, Donald Edmondson, Ian Kronish

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Background and Purpose: Posttraumatic stress disorder (PTSD) symptoms are common after stroke/transient ischemic attack (TIA) and have been associated with medication nonadherence, potentially because medications serve as traumatic reminders of the prior stroke/TIA. This study examined associations between stroke/TIA-induced PTSD and aversive cognitions toward preventive medications. Methods: We enrolled a cohort of patients presenting to the emergency department with suspected stroke/TIA. One month posthospitalization, we assessed PTSD symptoms specific to the index stroke/TIA using the PTSD checklist specific and asked patients how often (1) did thinking about your stroke medication make you feel nervous or anxious?; (2) did thinking about your stroke medication make you think about your risk for future strokes?; and (3) did you skip or avoid taking your stroke medication so you would not have to think about your stroke? Logistic regression models tested the association between PTSD symptoms and each aversive cognition, adjusting for age, sex, ethnicity, and depression. Results: Among 408 included patients, 11.0% had elevated PTSD symptoms. These patients were more likely to report that thinking about their stroke medication made them feel nervous or anxious (37.8% versus 9.9%, P<0.001) that thinking about their stroke medication made them think about their risk for future stroke/TIA (60.0% versus 24.0%, P<0.001), and that they skipped or avoided their stroke medication to not think about their prior stroke/TIA (11.1% versus 2.2%, P=0.009). In adjusted analyses, higher PTSD checklist specific scores were associated with increased nervousness/anxiety (odds ratio, 1.33 [95% CI, 1.18-1.50], P<0.001) and thoughts of future stroke (odds ratio, 1.27 [95% CI, 1.14-1.41], P<0.001), with a trend toward significance for skipping medications to avoid reminders of stroke (odds ratio, 1.20 [95% CI, 0.99-1.44], P=0.06). Conclusions: Medications may serve as traumatic reminders after stroke/TIA-induced PTSD, potentially leading to medication nonadherence.

Original languageEnglish
Pages (from-to)321-324
Number of pages4
JournalStroke
Volume52
Issue number1
DOIs
StatePublished - 1 Jan 2021
Externally publishedYes

Keywords

  • anxiety
  • association
  • depression
  • emergencies
  • hospitalization

Fingerprint

Dive into the research topics of 'Medications as Traumatic Reminders in Patients With Stroke/Transient Ischemic Attack-Induced Posttraumatic Stress Disorder'. Together they form a unique fingerprint.

Cite this