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创伤后应激障碍与慢性疾病按种族的关联。

The association of posttraumatic stress disorder and chronic medical conditions by ethnicity.

作者信息

Valentine Sarah E, Nobles Carrie J, Gerber Monica W, Vaewsorn Adin, Shtasel Derri L, Marques Luana

机构信息

Department of Psychiatry, Massachusetts General Hospital, Boston, MA.

Harvard Medical School, Boston, MA.

出版信息

J Lat Psychol. 2017 Aug;5(3):227-241. doi: 10.1037/lat0000076. Epub 2017 Jan 23.

Abstract

Our study extends the literature on associations between posttraumatic stress disorder (PTSD) and chronic medical conditions by assessing differences in the magnitude of these relations by ethnicity. We examined group differences in the magnitude of the relation between PTSD and chronic medical conditions (cardiovascular disease [CVD], hypertension, obesity, diabetes). We obtained data from Latino ( = 3,224) and non-Latino white ( = 4,180) respondents from the Collaborative Psychiatric Epidemiology Surveys. Logistic regression models were constructed to test for the modification of the effect of PTSD on chronic medical conditions by ethnicity, and then by nativity. Unadjusted models revealed significant interactions between Latino ethnicity and PTSD for odds of diabetes ( = 2.18 [Latino] v. 0.81 [non-Latino white]), CVD ( = 3.23 [Latino] v. 1.28 [non-Latino white]), and hypertension ( = 1.61 [Latino] v. 0.98 [non-Latino white]). Among U.S.-born Latinos, we found a significant interaction between ethnicity and PTSD for odds of CVD ( = 4.18 [Latino] v. 1.28 [non-Latino white]) and diabetes ( = 2.27 [Latino] v. 0.81 [non-Latino white]). These findings attenuated in adjusted models with the exception of differences in PTSD and odds of diabetes among Latinos (including aggregated group & U.S.-born) compared to non-Latino whites. Our findings support the need for further research on the complex relations between PTSD and chronic conditions, including the investigation of conditional risk by Latino sub-groups.

摘要

我们的研究通过评估这些关系在种族方面的差异程度,扩展了关于创伤后应激障碍(PTSD)与慢性疾病之间关联的文献。我们研究了PTSD与慢性疾病(心血管疾病[CVD]、高血压、肥胖症、糖尿病)之间关系程度的组间差异。我们从协作精神病流行病学调查中获取了拉丁裔(n = 3224)和非拉丁裔白人(n = 4180)受访者的数据。构建了逻辑回归模型,以检验种族以及出生地对PTSD对慢性疾病影响的调节作用。未调整的模型显示,拉丁裔种族与PTSD之间在患糖尿病几率(比值比 = 2.18[拉丁裔]对0.81[非拉丁裔白人])、CVD(比值比 = 3.23[拉丁裔]对1.28[非拉丁裔白人])和高血压(比值比 = 1.61[拉丁裔]对0.98[非拉丁裔白人])方面存在显著交互作用。在美国出生的拉丁裔中,我们发现种族与PTSD之间在患CVD几率(比值比 = 4.18[拉丁裔]对1.28[非拉丁裔白人])和糖尿病几率(比值比 = 2.27[拉丁裔]对0.81[非拉丁裔白人])方面存在显著交互作用。在调整后的模型中,这些发现有所减弱,但拉丁裔(包括总体群体和美国出生者)与非拉丁裔白人相比,PTSD与糖尿病几率之间的差异除外。我们的研究结果支持对PTSD与慢性疾病之间的复杂关系进行进一步研究,包括对拉丁裔亚组的条件风险进行调查。

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