Stroke complicAtions After TraUmatic expeRieNces and Stress

Study Overview
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Brief Summary
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The primary aim of this retrospective cohort study is to test the hypothesis that previous traumatization (long) before an ischemic stroke increases the degree of stroke-induced PTSD symptoms at 9-13 months after the stroke event. Secondary outcome parameters include quality of life and depression.

Detailed Description
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Neuropsychiatric consequences of brain ischemia play a critical role in shaping long-term stroke outcome. Unfortunately, however, as of now, clinical research and clinical practice have not adequately addressed this growing challenge. A good case in point is posttraumatic stress disorder (PTSD). Previous trauma exposure and posttraumatic stress symptoms may increase the risk of cardiovascular events (Sumner et al., 2015). Moreover, unbeknownst to most clinical neurologists, a significant portion (approximately 25%) of their stroke patients develop symptoms of post-traumatic stress disorder (PTSD) within the first year post-event. PTSD-related symptoms after an acute coronary syndrome increase the risk of recurrent cardiac events and mortality (Edmondson et al., 2012). Similarly, stroke-induced PTSD has been linked with worse long term stroke outcome, in particular, recurrent stroke, greater disability, non-adherence to medications, and comorbidities (Goldfinger et al., 2014; Kronish et al., 2012). For a period of 22 months, all stroke patients treated at the Charité Medical Center will be screened retrospectively 9-13 months after a first-ever ischemic stroke ( 2000). All eligible patients will be contacted by mail 9-13 months after their hospital stay with the request that they complete the questionnaires. The mailing will also include an information statement, the consent form, as well as a stamped return envelope.

Official Title
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Stroke complicAtions After TraUmatic expeRieNces and Stress - a Retrospective Cohort Study

Conditions
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Stroke

Intervention / Treatment
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* Diagnostic Test: Questionnaires


Participation Criteria
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Eligibility Criteria
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Inclusion criteria: Patients treated at the Charité Medical Center for acute ischemic stroke Confirmation of diagnosis by CT or MRI Age > 18 years Ability to give informed consent Exclusion criteria: Stroke secondary to complications from an intracranial aneurysm, arterial-venous malformation, intracranial tumor or neoplastic process Major diseases at the time of the hospital stay that would be expected to obviate meaningful follow-up assessments such as life-threatening heart or respiratory failure, renal or hepatic failure, cancer 2. Severe comprehension deficits, e.g. severe aphasia, dementia 3. Substantial pre-stroke disability (e.g. from a previous stroke)

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Diagnostic Test: Questionnaires|Psychological questionnaires: BTQ, IES-R, 7-items-short Screening scale, BDI, SF-36|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Stroke-induced PTSD | Stroke-induced PTSD will be measured using the Impact of Event Scale - Revised (IES-R). | 9-13 months after stroke | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Trauma exposure | Prior trauma exposure before the infarct is ascertained with the 10-item Brief Trauma Questionnaire (BTQ). | 9-13 months after stroke | 
| Lifetime PTSD | The occurrence of PTSD symptoms in the study subjects' lifetimes is assessed using the 7-item Short Screening Scale for DSM IV PTSD. | 9-13 months after stroke | 
| Functional outcome | Functional outcome is measured with the SF-36 | 9-13 months after stroke | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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ptsd, stress, traumatization