Neurology, Neuropsychiatry, Psychosomatics

Advanced search

Posttraumatic stress disorder after stroke: rate, risk factors, approaches to prevention and treatment

Full Text:


The rate of posttraumatic stress disorder (PTSD) averages 23% within the first year after stroke and 11% in succeeding years. Its risk is particularly high following subarachnoid hemorrhage or restroke in young patients and in patents with a history of mental illness. PTSD decreases quality of life in patients after stroke and their adherence to drugs for the secondary prevention of vascular diseases. PTSD patients are predisposed to post-stroke depressive disorders. PTSD treatment after stroke involves medication and psychotherapy.

About the Authors

M.A. Kutlubaev
G.G. Kuvatov Republican Clinical Hospital, Ufa
Russian Federation

L.R. Akhmadeeva
Bashkir State Medical University, Ministry of Health of Russia, Ufa
Russian Federation


1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). 4th ed. Washington DC: APA; 1994.

2. Norman P, O'Donnell ML, Creamer M, Barton J. Posttraumatic stress disorder after stroke: a review of quantitative studies, post traumatic stress disorders in a global context. Prof. Emilio Ovuga, MD, PhD (Ed.). 2012. Available from: (дата обращения: 15.11.2012).

3. Тарабрина НВ. Практикум по психологии посттравматического стресса. Санкт-Петербург: Питер, 2001. 272 c. [Tarabrina NV. Praktikum po psikhologii posttravmaticheskogo stressa [Workshop on psychology of a post-traumatic stress]. St-Petersburg: Piter, 2001. 272 p.]

4. Spindler H, Pedersen SS. Posttraumatic stress disorder in the wake of heart disease: prevalence, risk factors, and future research directions. Psychosom Med. 2005;67(5):715–23. DOI:

5. Sembi S, Tarrier N, O'Neill P, et al. Does post-traumatic stress disorder occur after stroke: a preliminary study. Int J Geriatr Psychiatry. 1998:13(5):315–22. DOI:;2-P.

6. Sampson MJ, Kinderman P, Watts S, Sembi S. Psychopathology and autobiographical memory in stroke and non-stroke hospitalized patients. Int J Geriatr Psychiatry. 2003;18(1):23–32. DOI:

7. Bruggimann L, Annoni JM, Staub F, et al. Chronic posttraumatic stress symptoms after nonsevere stroke. Neurology. 2006;66(4):513–6. DOI:

8. Merriman C, Norman P, Barton J. Psychological correlates of PTSD symptoms following stroke. Psychology, Health and Medicine. 2007;12:592–602. DOI:

9. Sharkey M. Post-traumatic stress symptomatology following stroke. PSIGE Newsletter. 2007;99:14–7.

10. Sagen U, Vik TG, Moum T, et al. Screening for anxiety and depression after stroke: comparison of the hospital anxiety and depression scale and the Montgomery and Asberg depression rating scale. J Psychosom Res. 2009;67(4):325–32. DOI: 10.1016/j.jpsychores. 2009.03.007. Epub 2009 Apr 17.

11. Sagen U, Finset A, Moum T, et al. Early detection of patients at risk for anxiety, depression and apathy after stroke. Gen Hosp Psychiatry. 2010;32(1):80–5. DOI: 10.1016/j.genhosppsych.2009.10.001. Epub 2009 Nov 12.

12. Wang X, Chung MC, Hyland ME, Bahkeit M. Posttraumatic stress disorder and psychiatric co-morbidity following stroke: the role of alexithymia. Psychiatric Res. 2011;188(1):51–7. DOI: 10.1016/j.psychres. 2010.10.002. Epub 2010 Oct 30.

13. Kronish IM, Edmondson D, Goldfinger J, et al. Posttraumatic stress disorder and adherence to medications in survivors of strokes and transient ischemic attacks. Stroke. 2012;43(8):2192–7. DOI: 10.1161/STROKEAHA.112.655209. Epub 2012 May 22.

14. Favrole P, Jehel L, Levy P, et al. Frequency and predictors of post-traumatic stress disorder after stroke: a pilot study. J Neurol Sci. 2013;327(1–2):35–40. DOI: 10.1016/j.jns.2013.02.001. Epub 2013 Mar 5.

15. Sheldrick R, Tarrier N, Berry E, Kincey J. Post-traumatic stress disorder and illness perceptions over time following myocardial infarction and subarachnoid hemorrhage. Br J Health Psychol. 2006;11(Pt 3):387–400. DOI:

16. Noble AJ, Baisch S, Mendelow AD, et al. Posttraumatic stress disorder explains reduced quality of life in subarachnoid hemorrhage patients in both the short and long term. Neurosurgery. 2008;63(6):1095–104. DOI: 10.1227/01.NEU.0000327580.91345.78.

17. Hedlund M, Zetterling M, Ronne-Engströ m E, et al. Depression and posttraumatic stress disorder after aneurysmal subarachnoid haemorrhage in relation to lifetime psychiatric morbidity. Br J Neurosurg. 2011;25(6):693–700. DOI: 10.3109/02688697.2011.578769. Epub 2011 May 18.

18. Baisch SB, Schenk T, Noble AJ. What is the cause of post-traumatic stress disorder following subarachnoid haemorrhage? Post-ictal events are key. Acta Neurochir (Wien). 2011;153(4):913–22. DOI: 10.1007/s00701-010-0843-y. Epub 2010 Oct 21.

19. Speck V, Noble A, Kollmar R, Schenk T. Diagnosis of spontaneous cervical artery dissection may be associated with increased prevalence of posttraumatic stress disorder. J Stroke Cerebrovasc Dis. 2013 Jul 10;23(2):335–42. DOI: 10.1016/j.jstrokecerebrovasdis.2013.03.033. Epub 2013 Jul 10.

20. Edmondson D, Richardson S, Fausett JK, et al. Prevalence of PTSD in Survivors of Stroke and Transient Ischemic Attack: A Meta-Analytic Review. PLoS One. 2013 Jun 19;8(6):e66435. DOI:

21. Field EL, Norman P, Barton J. Cross-sectional and prospective associations between cognitive appraisals and posttraumatic stress disorder symptoms following stroke. Behav Res Therapy. 2008;46(1):62–70. DOI: Epub 2007 Oct 13.

22. Noble AJ, Baisch S, Covey J, et al. Subarachnoid hemorrhage patients' fears of recurrence are related to the presence of posttraumatic stress disorder. Neurosurgery. 2011;69(2):323–32. DOI: 10.1227/NEU.0b013e318216047e.

23. Noble AJ, Schenk T. Posttraumatic stress disorder in the family and friends of patients who have suffered spontaneous subarachnoid hemorrhage. J Neurosurg. 2008;109(6):1027–33. DOI: 10.3171/JNS.2008.109.12.1027.

24. Парфенов ВА. Постинсультная депрессия: распространенность, патогенез, диагностика и лечение. Неврология, нейропсихиатрия, психосоматика. 2012;(4):84–7. [Parfenov VA. Poststroke depression: prevalence, pathogenesis, diagnosis, and treatment. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2012;(4):84–7. (In Russ.)]. DOI:

25. Вознесенская ТГ. Депрессия при цереброваскулярных заболеваниях. Неврология, нейропсихиатрия и психосоматика. 2009;(2):9–13. [Voskresenskaya TA. Depression in cerebrovascular diseases. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2009;(2):9–13. (In Russ.)]. DOI:

26. Старчина ЮА. Постинсультная депрессия: научно обоснованные подходы к выбору терапии. Неврология, нейропсихиатрия, психосоматика. 2012;(1):116–20. [Starchina VA. Post-stroke depression: scientifically substantiated approaches to choosing therapy. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2012;(1):116–20. (In Russ.)]. DOI:

27. Edmondson D, Horowitz CR, Goldfinger JZ, et al. Concerns about medications mediate the association of posttraumatic stress disorder with adherence to medication in stroke survivors. Br J Health Psychol. 2013 Nov;18(4):799–813. DOI: 10.1111/bjhp.12022. Epub 2013 Jan 7.

28. Edmondson D, Richardson S, Falzon L, et al. Posttraumatic stress disorder prevalence and risk of recurrence in acute coronary syndrome patients: A meta-analytic review. PLoS One. 2012;7(6):e38915. DOI: 10.1371/journal.pone.0038915. Epub 2012 Jun 20.

29. Horowitz M, Wilner NR, Alvarez W. Impact of Event Scale: a measure of subjective stress. Psychosom Med. 1979;41(3):209–18. DOI:

30. Hammarberg M. Penn inventory for PTSD: Psychometric properties. Psychological Assessment. 1992;4:67–76. DOI:

31. Weathers F, Litz B, Herman D, et al. The PTSD Checklist (PCL): reliability, validity, and diagnostic utility. Annual convention of the international society for traumatic stress studies. San Antonio, Texas; 1993.

32. Javidi H, Yadollahie M. Post-traumatic Stress Disorder. Int J Occup Environ Med. 2012;3(1):2–9.

33. Goldfinger JZ, Edmondson D, Kronish IM, et al. Correlates of Post-traumatic Stress Disorder in Stroke Survivors. J Stroke Cerebrovasc Dis. 2013 Oct 19. pii: S1052–3057(13)00393–5. DOI: 10.1016/j.jstrokecerebrovasdis.2013.09.019.

34. Jarvis A, Talbot L. Multiprofessional follow up of patients after subarachnoid haemorrhage. Br J Nurs. 2004;13(21):1262–7.

35. Thompson JN, Sheldrick R, Berry E. Cognitive and mental health difficulties following subarachnoid haemorrhage. Neuropsychol Rehabil. 2011;21(1):92–102. DOI: 10.1080/09602011.2010.529748. Epub 2010 Dec 1.

36. Хасанова ДР, Житкова ЮВ. Применение эсциталопрама для профилактики синдрома депрессии и когнитивных нарушений в остром периоде инсульта. Неврология, нейропсихиатрия, психосоматика. 2013;(2S):16–22. [Khasanova DR, Zhitkova YuV. Use of escitalopram to prevent depression and cognitive impairments in the acute phase of stroke. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2013;(2S):16–22. (In Russ.)]. DOI:

37. Mead GE, Hsieh CF, Lee R, et al. Selective serotonin reuptake inhibitors for stroke recovery: a systematic review and metaanalysis. Stroke. 2013;44(3):844–50. DOI: 10.1161/STROKEAHA.112.673947. Epub 2013 Jan 29.

For citation:

Kutlubaev M., Akhmadeeva L. Posttraumatic stress disorder after stroke: rate, risk factors, approaches to prevention and treatment. Neurology, Neuropsychiatry, Psychosomatics. 2014;6(2):70-74. (In Russ.)

Views: 708

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)