A prospective study of posttraumatic stress symptoms and nonadherence in survivors of a myocardial infarction (MI)

Eyal Shemesh, Abraham Rudnick, Edo Kaluski, Olga Milovanov, Ahmed Salah, Daniela Alon, Irit Dinur, Alex Blatt, Mikael Metzkor, Ahuva Golik, Zvi Verd, Gad Cotter

Research output: Contribution to journalArticlepeer-review

139 Scopus citations

Abstract

We examined a novel hypothesis that links symptoms of MI-related posttraumatic stress disorder (PTSD) to nonadherence. According to this hypothesis, patients who are traumatized by their medical illness do not take their medications as prescribed. As a part of the avoidance dimension of PTSD, patients who are traumatized may avoid being reminded of the MI by not taking the medication. MI survivors were prospectively followed for 6 months to 1 year. Adherence was assessed by pill count of Captopril. Demographic variables, medical risk factors, PTSD, and other psychiatric symptom dimensions were evaluated during follow-up. One hundred two of 140 recruited patients completed follow-up. Nonadherence to Captopril was associated with poor medical outcome (r=.93, P=.006). Above-Threshold PTSD symptoms were associated with nonadherence to medications (P=.05). No other psychiatric symptom dimensions were independently associated with nonadherence. Nonadherence to medications predicts adverse outcome during the first year after an acute MI. Nonadherence is associated with PTSD symptoms, which may either be a marker for or a cause of nonadherence. Treatment of PTSD may prove to be a useful approach for improving adherence.

Original languageEnglish
Pages (from-to)215-222
Number of pages8
JournalGeneral Hospital Psychiatry
Volume23
Issue number4
DOIs
StatePublished - 2001
Externally publishedYes

Keywords

  • MI
  • Nonadherence
  • PTSD

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