Prevalence of posttraumatic stress disorder after stroke: A systematic literature review

Background: Posttraumatic stress disorder (PTSD) has shown to be related to worse functional outcome in individuals with stroke. This systematic literature review aimed to 1) provide a comprehensive overview of the evidence of prevalence of PTSD after stroke; 2) explore possible differences in prevalence between pathogenic origin of stroke and location of lesion; and 3) explore possible differences in prevalence between method of assessment of PTSD. Methods: A systematic literature search was performed on studies reporting on PTSD post-stroke. Risk of bias was assessed using an adapted version of the Joanna Briggs Institute's critical appraisal tool. Results: Thirty studies, reporting on 4320 individuals, were included. The weighted median PTSD prevalence overall was 17.5 % (2.9 %–71.4 %), in ischemic stroke 13.8 %, in transient ischemic attack 4.6 %, in intracerebral hemorrhage 6.5 %, and in subarachnoid hemorrhage 37.1 %. The weighted median prevalence based on self-report questionnaires was 17.8 % (3.7 %–71.4 %,) and based on PTSD interviews 4.0 % (2.9 %–32.8 %). At three and ≥ 12 months post-stroke the weighted median prevalence was respectively 24.7 % (0.0 %–37.1 %) and 17.8 % (6.5 %–71.4 %). Conclusion: Results suggest that PTSD is common after stroke, and even more so after subarachnoid hemorrhage. This underlines the importance of awareness of and screening for PTSD post-stroke, even after the first year post-stroke.