Psychological Factors and Post-Traumatic Stress Disorder (PTSD) Risk in Stroke Survivors: A Cross-Sectional Study.

Abstract

Introduction: As of 2023, stroke is the second leading cause of death and the third leading cause of death and disability globally, with an expected rise by 2030. While traditional risk factors like demographics, smoking, inactivity, diabetes, and hypertension are well-known, post-traumatic stress disorder (PTSD) remains under-studied despite its 13% incidence rate and link to stroke risk.

Methods: This cross-sectional study, conducted from 1^st November, 2023 to 30^th January, 2024 in Doanhung, Phutho Province, involved stroke patients over 18 years old diagnosed within the past year. A 56-question questionnaire assessed demographics, clinical characteristics, the Barthel Index, and the PTSD Checklist for DSM-5 (PCL-5). Multivariable logistic regression using Stepwise AIC identified optimal models related to PTSD.

Results: A cohort of 397 participants, with a mean age of 67.98 years and 54.9% female, had a PTSD prevalence of 10.8%. Significant PTSD predictors included regular alcohol consumption (OR=11.43, 95% CI: 1.30-99.15, p=0.027), slight memory decrease (OR=3.59, 95% CI: 1.28-10.62, p=0.017), female gender (OR=3.15, 95% CI: 1.08-10.44, p=0.045), extroverted personality (OR=4.36, 95% CI: 1.73-11.86, p=0.003), and Barthel Index scores (OR=0.85, 95% CI: 0.80-0.90, p<0.001). However, age showed marginally significant association with PTSD (OR=0.97, 95% CI: 0.94-1.00, p=0.067), and unconsciousness during stroke (yes) had an OR of 2.43 (95% CI: 0.96-6.04, p=0.056).

Conclusion: This study highlights the complex interplay of demographic, lifestyle, and clinical factors influencing PTSD risk in stroke survivors. Addressing these factors in interventions is crucial to reduce the psychological burden and improve rehabilitation outcomes.