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von Känel, R.* ; Baumert, J.J. ; Kolb, C.* ; Cho, E.Y.* ; Ladwig, K.-H.

Chronic posttraumatic stress and its predictors in patients living with an implantable cardioverter defibrillator.

J. Affect. Disord. 131, 344-352 (2011)
DOI PMC
Open Access Green as soon as Postprint is submitted to ZB.
Patients with an implantable cardioverter defibrillator (ICD) show clinically relevant depression and anxiety, but little is known about their levels of posttraumatic stress. We assessed chronic posttraumatic stress attributable to a traumatic cardiac event and its predictors in patients at two time points after ICD placement. METHODS: We investigated 107 consecutively enrolled patients (57±14years, 62% men) on average 24±21months after ICD placement (baseline) and again 41±18months later (follow-up). All patients completed the Impact of Event Scale-Revised (IES-R) to self-rate the severity of posttraumatic stress (range 0-110). The 30% of patients with the highest IES-R scores (≥25) at baseline were defined as PTSD cases; the same threshold was applied to define PTSD caseness at follow-up. RESULTS: Posttraumatic stress increased from baseline to follow-up (19±22 vs. 25±19, p<0.001); 19% of patients had PTSD at both assessments, 12% at baseline only, and 18% at follow-up only. Female gender as well as greater peritraumatic dissociation and depression predicted greater posttraumatic stress at baseline (p-values≤0.041). Greater baseline posttraumatic stress, helplessness, alexithymia, and ≥5 shocks during follow-up all predicted greater posttraumatic stress at follow-up (p-values≤0.029). Female gender, helplessness, and depression predicted PTSD at baseline (p-values≤0.022); low education and posttraumatic stress at baseline predicted PTSD at follow-up (p-values≤0.003). CONCLUSIONS: Between 2 and 5.5years post-ICD placement chronic posttraumatic stress slightly increased and nearly one-fifth of patients had newly developed PTSD. The identified psychological predictors of long-term chronicity of posttraumatic stress might particularly inform behavioral interventions for ICD recipients.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords Cardiovascular disease; Implantable cardioverter defibrillator; Posttraumatic stress disorder; Psychological stress; Trauma
ISSN (print) / ISBN 0165-0327
e-ISSN 1573-2517
Journal Journal of Affective Disorders
Quellenangaben Volume: 131, Issue: 1-3, Pages: 344-352 Article Number: , Supplement: ,
Publisher Elsevier
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Epidemiology II (EPI2)