Miller Kenneth, Driscoll David, Smith Lynette M, Ramaswamy Sriram
Department of Psychiatry, Creighton University School of Medicine, 3528 Dodge Street, Omaha, NE 68131.
VA Nebraska-Western Iowa Health Care System, 4101 Woolworth Avenue, Omaha, NE, 68105.
Mil Med. 2017 Nov;182(11):e1815-e1818. doi: 10.7205/MILMED-D-17-00073.
There is evidence that immune system dysregulation and inflammation may play a role in the development of post-traumatic stress disorder (PTSD). Previous studies have reported elevated levels of inflammatory markers such as C-reactive protein (CRP) in individuals with PTSD. However, it is unclear whether exacerbation of PTSD symptoms late in life is also associated with elevated inflammation. The purpose of this pilot study was to examine the relationship between inflammation and late-life PTSD.
We recruited veterans either diagnosed with PTSD after the age of 55 or with no diagnosis of PTSD. Six veterans did not meet all eligibility criteria, including five who did not meet criteria for PTSD and one with celiac disease. The final sample included a total of 32 male veterans (16 veterans diagnosed with PTSD after 55 and 16 veterans without PTSD). The groups were matched as closely as possible on age, body mass index, and combat exposure. PTSD symptoms were assessed using the Clinician-Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and depressive symptoms were assessed using the Hamilton Rating Scale for Depression. Inflammation was measured using serum CRP level.
The two groups did not differ on sample characteristics including age, body mass index, tobacco use, medication use, and military history. CRP level was found to be significantly higher in the PTSD group than in the comparison group (Z = -3.047, p = 0.002), which was also observed after adjusting for depression scores (F(1, 27) = 8.30, p = 0.0077).
The results from this pilot study suggest that late-life PTSD may be associated with increased inflammation. Further research in larger samples is needed to corroborate these findings and to clarify the relationship between inflammation and PTSD, which may lead to improved methods of diagnosis and treatment.
有证据表明免疫系统失调和炎症可能在创伤后应激障碍（PTSD）的发展中起作用。先前的研究报告称，PTSD患者体内炎症标志物如C反应蛋白（CRP）水平升高。然而，尚不清楚晚年PTSD症状的加重是否也与炎症加剧有关。这项初步研究的目的是探讨炎症与晚年PTSD之间的关系。
我们招募了55岁后被诊断患有PTSD或未被诊断患有PTSD的退伍军人。6名退伍军人不符合所有入选标准，包括5名不符合PTSD标准的人和1名患有乳糜泻的人。最终样本共包括32名男性退伍军人（16名55岁后被诊断患有PTSD的退伍军人和16名未患PTSD的退伍军人）。两组在年龄、体重指数和战斗经历方面尽可能进行匹配。使用《精神障碍诊断与统计手册》第五版的临床医生管理的PTSD量表评估PTSD症状，使用汉密尔顿抑郁量表评估抑郁症状。通过血清CRP水平测量炎症。
两组在年龄、体重指数、吸烟情况、用药情况和军事历史等样本特征方面没有差异。发现PTSD组的CRP水平显著高于对照组（Z = -3.047，p = 0.002），在调整抑郁评分后也观察到这种情况（F(1, 27) = 8.30，p = 0.0077）。
这项初步研究的结果表明，晚年PTSD可能与炎症增加有关。需要在更大样本中进行进一步研究以证实这些发现，并阐明炎症与PTSD之间的关系，这可能会导致诊断和治疗方法的改进。
