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Title: Post-traumatic Stress Disorder in Chronic Cardiopulmonary Disease
Author: Jones, R. C.
Awarding Body: Universities of Exeter and Plymouth
Current Institution: University of Exeter
Date of Award: 2008
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This work aims to examine the prevalence and impact of post-traumatic stress disorder (PTSD) in people with ischaemic heart disease (IHD) and chronic obstructive pulmonary disease (COPD). Post-traumatic stress disorder is widely underdiagnosed and may be associated with negative effects on health-related behaviour, including smoking, diet, exercise, seeking appropriate treatment and compliance with prescribed medication. Depression after myocardial infarction (MI) is known to be associated with adverse cardiovascular outcomes, butless is known about PTSD after MI. This thesis consists of the following: A systematic review of the prevalence and impacts of PTSD after MI, which found 15 studies that presented original research data involving 974 participants. The prevalence of PTSD ranged from 0% to 25%; the pooled prevalence was 14.7%. Inadequate information was available to confirm an association between PTSD and adverse cardiovascular outcomes after MI. A study of 112 patients with a previous diagnosis of MI recruited from primary was carried out. Overall, 32% of patients had PTSD related to their MI, and that PTSD was associated with significant psychological morbidity. No evidence, however, suggested that people with PTSD after MI were more likely to have risk factors for future cardiovascular events. A study of the prevalence of PTSD in 100 patients with COPD referred to a pulmonary rehabilitation programme found that 8% had PTSD~ Post-traumatic stress disorder was associated with impaired health status. Symptoms of PTSD did not improve after pulmonary rehabilitation despite improvements in other aspects of health,.status. In neither patients with COPD nor patients with IHD was PTSO associated with smoking. In conclusion, PTSO is not uncommon in patients with IHD and COPO and is largely undetected. PTSD is associated with both psychological symptoms and increased symptom burden related to the chronic illness. In patients with IHO, Iwas unable to confirm previous findings that PTSO is associated with poor 3 compliance, unhealthy behavioural patterns and increased risk factors for progression of IHO. Insufficient evidence was found to conclude that PTSO is a cause of adverse outcomes in patients with COPD. The relation between psychological factors and the development, progression and risk of acute events in patient with IHD and COPD merits further research.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available