Elevated symptoms of posttraumatic stress disorder (PTSD) are more common after stroke mimics than after actual stroke, according to a study in General Hospital Psychiatry.
Why It’s Relevant
Stroke mimics are stroke-like symptoms that ultimately receive other diagnoses such as migraine, peripheral neuropathy, or functional neurological disorder. Though individuals with stroke mimics have better functional outcomes than those with actual strokes, they still experience significant distress during the diagnostic process. These patients may benefit from early screening for PTSD symptoms along with psychoeducation and resources relevant to their final diagnosis.
By the Numbers
- The study investigators analyzed 949 emergency department (ED) patients with suspected stroke or transient ischemic attacks (TIAs). Of this group, 274 patients were ultimately diagnosed with a stroke mimic.
- At one-month follow-up, 13.5% of patients with stroke mimics had elevated PTSD symptoms, compared with 6.4% of those with confirmed stroke or TIA. PTSD symptoms were assessed using the PTSD Checklist for DSM-5.
- Adjusting for demographics, stroke severity, functional status at discharge, and baseline PTSD symptoms, patients with stroke mimics had 2.6 times the odds of having elevated PTSD symptoms at follow-up compared with patients with confirmed stroke or TIA.
The Other Side
The researchers excluded patients with severe stroke, and only 3% of enrolled patients were classified with moderate-severe stroke, which may have influenced the discrepancy in PTSD symptoms between the stroke and stroke mimic groups.
Takeaway Message
“This study highlights a potential gap in frameworks of care for patients arriving at the ED with suspected stroke, highlighting that—even in the absence of a life-threatening cerebrovascular accident—clinically significant psychological distress may still be present,” the study investigators wrote. “Clinicians should address the needs of all patients presenting with stroke-like symptoms, regardless of their ultimate diagnosis.”
Related Information
Source
Jeffrey L. Birk, et. al. Higher risk for elevated PTSD symptoms in patients with stroke mimics versus confirmed stroke or TIA.
General Hospital Psychiatry. Published January 22, 2026. doi:
doi.org/10.1016/j.genhosppsych.2026.01.011
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