Post-traumatic stress disorder and its risk factors in Japanese patients living with implantable cardioverter defibrillators: A preliminary examination

BackgroundTrauma reactions, including post-traumatic stress disorder (PTSD), in patients with implantable cardioverter defibrillators (ICDs) have recently garnered increased attention. The aim of this preliminary study was to examine the incidence of and risk factors for PTSD and to assess its impact on psychosocial distress and health-related quality of life (QOL) in Japanese patients with ICD.MethodsSeventy-four outpatients with ICD (63 men, 11 women; age 59.3±13.6 years) completed a questionnaire comprising a modified PTSD Checklist Specified for a stressor that included arrhythmias and ICD shocks, the Zung Self-Rating Depression Scale (SDS), the State-Trait Anxiety Inventory (STAI)-State scale, and Medical Outcomes Study 36-item Short-Form (SF-36) for health-related QOL. We compared relevant sociodemographic and medical variables of patients with and without PTSD. The mean number of days since ICD implantation was 2471±703.ResultsOf 74 patients, 28 (37.8%) had received ICDs for secondary prevention, 42 (56.8%) had experienced ICD shocks, 36 (48.6%) had experienced ≥1 appropriate ICD shock, and 12 (16.2%) had experienced electrical storms. We diagnosed 19 patients (25.8%) with PTSD. Compared with the non-PTSD group, the PTSD group had significantly higher SDS and STAI-S scores and significantly lower scores in all eight subscales of the SF-36. Multiple logistic regression analysis identified experiencing ≥1 appropriate ICD shock (odds ratio [OR]: 6.0, 95% confidence interval [CI]: 1.45–24.63, and p<0.013) and anxiolytic use (OR: 15.0, 95% CI: 3.38–66.26, and p<0.001) as independent risk factors for PTSD.ConclusionsOur study shows that PTSD in patients with ICD has significant psychosocial impact with associated impairment of both physical and mental QOL and suggests that, in particular, patients who experience appropriate ICD shocks or take anxiolytics require psychiatric/psychological intervention.