Prevalence of posttraumatic stress disorder after stroke: A systematic literature review

• Published in: Journal of psychosomatic research 2024-12, Vol.187, p.111914, Article 111914
• Main Authors: Janssen, E.P.J., Spauwen, P.J.J., Bus, B.A.A., Rijnen, S.J.M., Ponds, R.W.H.M.
• Format: Article
• Language: English
• Subjects: Brain diseases; Cerebrovascular disorders; Epidemiology; Humans; Mental disorders; Prevalence; Stress Disorders, Post-Traumatic - epidemiology; Stress Disorders, Post-Traumatic - psychology; Stroke - complications; Stroke - epidemiology; Stroke - psychology; Trauma and stressor related disorders
• ISSN: 0022-3999; 1879-1360; 1879-1360
• DOI: 10.1016/j.jpsychores.2024.111914

Posttraumatic stress disorder (PTSD) has shown to be related to worse functional outcome in individuals with stroke. This systematic literature review aimed to 1) provide a comprehensive overview of the evidence of prevalence of PTSD after stroke; 2) explore possible differences in prevalence between pathogenic origin of stroke and location of lesion; and 3) explore possible differences in prevalence between method of assessment of PTSD. A systematic literature search was performed on studies reporting on PTSD post-stroke. Risk of bias was assessed using an adapted version of the Joanna Briggs Institute's critical appraisal tool. Thirty studies, reporting on 4320 individuals, were included. The weighted median PTSD prevalence overall was 17.5 % (2.9 %–71.4 %), in ischemic stroke 13.8 %, in transient ischemic attack 4.6 %, in intracerebral hemorrhage 6.5 %, and in subarachnoid hemorrhage 37.1 %. The weighted median prevalence based on self-report questionnaires was 17.8 % (3.7 %–71.4 %,) and based on PTSD interviews 4.0 % (2.9 %–32.8 %). At three and ≥ 12 months post-stroke the weighted median prevalence was respectively 24.7 % (0.0 %–37.1 %) and 17.8 % (6.5 %–71.4 %). Results suggest that PTSD is common after stroke, and even more so after subarachnoid hemorrhage. This underlines the importance of awareness of and screening for PTSD post-stroke, even after the first year post-stroke. •PTSD is common post-stroke, overall affecting 18 % of stroke patients.•PTSD affected 14 % of the individuals with ischemic stroke.•PTSD affected 37 % of the individuals with subarachnoid hemorrhage.•Self-report questionnaires generated higher prevalence rates relative to interviews.•Remission rate of PTSD in individuals with stroke seems limited.