Incidence and predictors of post-traumatic stress symptoms in a cohort of patients with intracerebral hemorrhage

•In one of the larger cohorts to-date examining post-stroke post-traumatic stress disorder (PTSD), we observe a roughly 6.5 % incidence of novel PTSD symptoms (meeting clinical criteria for diagnosis) after an intracerebral hemorrhage, markedly lower from what has been posited in related research on subarachnoid hemorrhage or ischemic stroke.•The presence of PTSD symptoms is associated with poorer functional outcomes; although the latter is associated with stroke severity, disability at onset, stroke prognosis, hospital/ICU course, and other related variables, PTSD symptoms appear to develop independently.•Age and gender, though strong predictors of PTSD in the general population, do not appear to be related in this post-stroke cohort.•As such, there may be other underlying genetic factors, or else uncaptured sociodemographic or post-hospitalization variables that interact to give rise to PTSD symptoms. Examine the incidence and predictors of PTSD symptoms in a cohort of patients with ICH. This study uses a prospective cohort of 108 patients with complete follow-up data including a questionnaire regarding stress symptoms (PCL-S: PTSD checklist specific for a stressor) at 3, 6, and 12 months. The incidence of novel stress symptoms following ICH was approximately 6.5%. Age was negatively associated with PTSD symptoms with only trend-level significance (3 months: OR = 0.83, p = 0.087; 6 months: OR = 0.70, p = 0.015; 12 months: OR = 0.88, p = 0.087). Gender did not affect PTSD symptom development, (t = 1.34, p = 0.18). Pre-morbid functioning, initial stroke prognosis, total number of complications, and length of hospital/ICU stay were not associated with PTSD symptoms; however, each was significantly correlated with poorer functional outcomes. Yet, poorer functional outcomes were observed in those with higher reports of PTSD symptoms (r = 0.24, p = 0.01). Functional outcomes in ICH are correlated with PTSD symptoms, however the mechanism and relationship are difficult to elucidate. Further research is needed to determine possible mechanisms by which a stroke patient may develop PTSD.