National Institutes of Health National Institutes of Nursing Research, 10 Center Drive, Bethesda, MD 20892, USA.
National Institutes of Health National Institutes of Nursing Research, 10 Center Drive, Bethesda, MD 20892, USA.
Psychiatry Res. 2014 Apr 30;216(1):116-22. doi: 10.1016/j.psychres.2014.01.046. Epub 2014 Feb 5.
Military personnel who have combat exposures are at increased risk for the service-related disorders of post-traumatic stress disorder (PTSD), depression, sleep disturbances and decreased health related quality of life (HRQOL). Those with a traumatic brain injury (TBI) are at even greater risk. Inflammation is associated with these disorders and may underlie the risk for health declines. We evaluated 110 recently deployed, military personnel presenting with sleep disturbances for service-related disorders (TBI, PTSD, and depression) as well as HRQOL. ANOVA models were used to examine differences among military personnel with two or more service-related disorders (high comorbid group), or one or no disorders (low comorbid group). Logistic regression models were used to determine associations among interleukin-6 (IL-6) to HRQOL and service-related disorders. Approximately one-third of the sample had two or more service-related disorders. HRQOL was lower and IL-6 concentrations were higher in military personnel with PTSD or depression, with the most profound differences in those with more service-related disorders, regardless of sleep disorder. Having symptoms of depression and PTSD resulted in a 3.5-fold risk to be in the lower quartile of HRQOL and the highest quartile of IL-6. In a linear regression model, 41% of the relationship between HRQOL and IL-6 concentrations was mediated by PTSD and depression. Military personnel with PTSD and depression are at high risk for lower HRQOL, and higher IL-6 concentrations. Comprehensive treatment is required to address co-occurring service-related disorders in military personnel to promote health and well-being.
有战斗经历的军人患创伤后应激障碍（PTSD）、抑郁、睡眠障碍和健康相关生活质量（HRQOL）下降等与服役相关的疾病的风险增加。有创伤性脑损伤（TBI）的军人风险更高。炎症与这些疾病有关，可能是健康状况下降的原因。我们评估了 110 名最近部署的、有睡眠障碍的军人，他们患有与服役相关的疾病（TBI、PTSD 和抑郁）以及 HRQOL。使用方差分析模型来检查有两种或两种以上与服役相关的疾病（高共病组）或一种或没有疾病（低共病组）的军人之间的差异。使用逻辑回归模型来确定白细胞介素-6（IL-6）与 HRQOL 和与服役相关的疾病之间的关联。大约三分之一的样本有两种或两种以上与服役相关的疾病。患有 PTSD 或抑郁的军人的 HRQOL 较低，IL-6 浓度较高，而且有更多与服役相关的疾病的军人差异最大，无论是否有睡眠障碍。出现抑郁和 PTSD 症状会使 HRQOL 处于较低四分位和 IL-6 最高四分位的风险增加 3.5 倍。在线性回归模型中，HRQOL 和 IL-6 浓度之间 41%的关系是由 PTSD 和抑郁介导的。患有 PTSD 和抑郁的军人的 HRQOL 较低，IL-6 浓度较高，风险很高。需要进行全面治疗以解决军人中同时存在的与服役相关的疾病，以促进健康和幸福。
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