Abstract Body: Introduction: Posttraumatic stress disorder (PTSD) has emerged as a mental health barrier that can be experienced by survivors of stroke. PTSD triggered by thoughts of stroke impacts a patient’s ability to optimize their health outcome and maintain compliance with secondary prevention. A young adult stroke clinic treating survivors aged 18-50 in an urban setting in Maryland implemented a standardized practice to screen all patients for PTSD. A retrospective data analysis was performed to determine prevalence of PTSD in the young stroke population and identify predictive characteristics.
Methods: Clinic patients were eligible for screening if they were survivors of ischemic or hemorrhagic stroke. The PCL-5 was utilized as the validated PTSD screening tool. Patients were asked to think about their stroke as the stressful event when answering the questions on the tool. A score on the PCL-5 of ≥ 31 was considered positive for PTSD and < 31 was negative. Only the initial screening for each patient was included in the analysis. Additional data collected included demographics, medical history, mental health history, substance use at time of stroke, and mRS at the time of visit. Data collection began in September 2023. Univariate analysis was done to identify which characteristics are associated with developing symptoms of PTSD after stroke.
Results: A total of 106 young stroke survivors were screened. Mean age of first stroke was 39.5 years (range 5-50), 57.5% were female (61/106), and 57.5% were black (61/106). PTSD was prevalent in young adult stroke survivors at a rate of 17% (18/106). Compared to patients without the following characteristics, there was a significant increase in the rate of developing PTSD after stroke for patients with a history of anxiety (OR 5.1, 95% [1.2-21.5]) or active smoking (OR 3.8, 95% [1.18-12.4]). The remaining characteristics did not have statistically significant associations with PTSD.
Conclusion: PTSD prevalence in this age group of stroke survivors is consistent with what is reported in the literature for all stroke survivors. Preliminary analysis shows there may be predictive characteristics of young stroke survivors who develop PTSD, which can impact their recovery and secondary prevention. The first months are the most impactful in stroke recovery. Further data collection and analysis should be done in this population to look for additional characteristics associated with PTSD to identify at-risk patients early.