Sex differences in post-traumatic stress disorder in cardiovascular patients after the Great East Japan Earthquake: A report from the CHART-2 Study

Takeo Onose, Yasuhiko Sakata, Kotaro Nochioka, Masanobu Miura, Takeshi Yamauchi, Kanako Tsuji, Ruri Abe, Takuya Oikawa, Shintaro Kasahara, Masayuki Sato, Takashi Shiroto, Satoshi Miyata, Jun Takahashi, Hiroaki Shimokawa

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Aims The temporal changes and sex differences in post-traumatic stress disorder (PTSD) after natural disasters remain unclear. Therefore, we examined the prevalence, prognostic impacts, and determinant factors of PTSD after the Great East Japan Earthquake (GEJE) of 11 March 2011 in cardiovascular (CV) patients registered in the Chronic Heart Failure Analysis and Registry in the Tohoku District (CHART)-2 Study (n = 10 219), with a special reference to sex. Methods and results By self-completion questionnaires of the Japanese-language version of the Impact of Event Scale-Revised (IES-R-J), the prevalence of PTSD, defined as IES-R-J score ≥25, was 14.8, 15.7, 7.4, and 7.5% in 2011, 2012, 2013, and 2014, respectively. The PTSD rate was higher in women than in men in all years (all P < 0.01). During a median 3.5-year follow-up period, the patients with PTSD in 2011 more frequently experienced a composite of all-cause death and hospitalization for acute myocardial infarction, stroke, and heart failure than those without PTSD [adjusted hazard ratio (aHR) 1.27, P < 0.01]. Importantly, the prognostic impacts of PTSD on all-cause death (aHR 2.10 vs. 0.87, P for interaction = 0.03) and CV death (aHR 3.43 vs. 0.90, P for interaction = 0.02) were significant in women but not in men. While insomnia medication was a prominent determinant factor of PTSD in both sexes during 2011-14, economic poverty was significantly associated with PTSD only in men. Conclusion After the GEJE, marked sex differences existed in the prevalence, prognostic impacts, and determinant factors of PTSD, suggesting the importance of sex-sepcific mental stress care in disaster medicine.

Original languageEnglish
Pages (from-to)224-233
Number of pages10
JournalEuropean Heart Journal - Quality of Care and Clinical Outcomes
Volume3
Issue number3
DOIs
Publication statusPublished - 2017 Jan 1

Keywords

  • Epidemiology
  • Mental disorder
  • Post-traumatic stress disorder
  • Prognosis
  • The Great East Japan Earthquake

ASJC Scopus subject areas

  • Health Policy
  • Cardiology and Cardiovascular Medicine

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