Highlights 2009:
Posttraumatic stress symptoms predict mortality in patients with Implantable Cardioverter Defibrillators (ICD). Results from the prospective Living with an Implantable Cardioverter Defibrillator (LICAD) Study
Prof. Dr. Karl-Heinz Ladwig, ladwig@helmholtz-muenchen.de, +49-(0)89-3187-3623
Keywords:
Posttraumatic stress, implantable cardioverter defibrillators, case fatality
Central statement:
Patients treated with an implantable cardioverter defibrillator and followed for an observation period of approximately 5 years who suffer from severe PTSD symptoms yield an adjusted 3.5-fold higher mortality risk compared to patients without PTSD symptoms.
Highlight:
Cardiadiac arrest survivors with post-traumatic stress disorder (PTSD) need special psychological aftercare, since they have a clearly higher mortality risk than patients without PTSD. This is the conclusion scientists of the Institute of Epidemiology have drawn from a prospective cohort study which they carried out with partners at the Technische Universität München and the German Heart Center Munich.
About 150 patients who received an implantable cardioverter-defibrillator (ICD) after a severe cardiac infarction or cardiac arrest were followed up over a period of five years with special focus on their psychological health. A portion of the patients showed marked PTSD symptoms and experienced recurring intrusive memories of their disease. This patient group showed a 3.5-fold higher mortality risk compared to patients without PTSD symptoms who were able to come to terms with their disease. Other factors also influencing these patients’ ability to survive, such as age, the ejection fraction as measure of the remaining myocardial contractility or diabetes mellitus, are not associated with the PTSD symptoms. Surprisingly, the researchers found no association with the presence of co-morbid depression and anxiety.
Publication:
Ladwig KH, Baumert J, Marten-Mittag B, Kolb C, Zrenner B, Schmitt C.: Posttraumatic stress symptoms and predicted mortality in patients with implantable cardioverter-defibrillators: results from the prospective living with an implanted cardioverter-defibrillator study. Arch. Gen. Psychiatry 65, 1324-1330 (2008)
Abstract
Taking account of the HMGU mission:
Chronic diseases, such as cardio-vascular diseases, lie at the core of HMGU interest – diseases that are influenced to a high degree by personal risk factors but also environmental factors. Here, we investigate the interaction of mental health features with serious somatic disease conditions and show that the internal environment (negative affect state) impacts substantially outcome in cardiac disease conditions. Further research is warranted to bridge the gap between mental and somatic health conditions in detail.