81POST-TRAUMATIC STRESS DISORDER AFTER MILD STROKE AND TRANSIENT ISCHAEMIC ATTACK: PSYCHIATRIC CO-MORBIDITY AND SYMPTOM CLUSTER DISTRIBUTION

Abstract

Background and Aims: Post-traumatic stress disorder (PTSD) is distressing and may be common after stroke and transient ischaemic attack (TIA). A better understanding of the overlap between PTSD with other common post-stroke neuropsychiatric sequelae?depression, anxiety, cognitive impairment can help us develop better psychological support to patients post-stroke/TIA. Method: We followed up mild stroke and TIA patients at three months using diagnostic psychiatric interview (SCID-DSM-IV) and telephone Montreal Cognitive Assessment (tMOCA). Results: Of 175 participants (mean age 70; 40% women; 65% stroke; 35% TIA), 11/175, 6% (95%CI 3-11%) met the diagnostic criteria for PTSD. Almost half of all PTSD cases (5/11) were also diagnosed with a depressive episode. All PTSD cases (11/11) were co-morbid with one or more anxiety disorders (phobic disorder or generalized anxiety disorder). Median tMOCA score was 19 and the same in PTSD and non- PTSD cases. PTSD symptom clusters C) persistent avoidance and numbing of general responsiveness, and D) increased arousal were present in over 10% of our stroke and TIA cohort. Conclusion: Clinical diagnosis of PTSD is present in around 6% of mild stroke and TIA patients at 3 months. There is considerable overlap between PTSD with depression and anxiety disorders. PTSD symptoms are common even in those without PTSD diagnosis. Psychological support for stroke and TIA should consider targeting these common symptom clusters.