El-Gabalawy Renée, Blaney Caitlin, Tsai Jack, Sumner Jennifer A, Pietrzak Robert H
Department of Anesthesia and Perioperative Medicine, University of Manitoba, Winnipeg, MB, Canada; Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada; Department of Psychology, University of Manitoba, Winnipeg, MB, Canada; Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada.
Department of Anesthesia and Perioperative Medicine, University of Manitoba, Winnipeg, MB, Canada; Department of Psychology, University of Manitoba, Winnipeg, MB, Canada.
J Affect Disord. 2018 Feb;227:849-853. doi: 10.1016/j.jad.2017.11.058. Epub 2017 Nov 15.
While both full and subthreshold posttraumatic stress disorder (PTSD) may be linked to physical conditions, contemporary population-based data on these associations in military veterans are scarce. Further, little is known about how component aspects of PTSD, which is a heterogeneous disorder, may relate to physical conditions in this population.
Data were analyzed from a population-based sample of 3157 U.S. military veterans who participated in the 2011 National Health and Resilience in Veterans Study. Multiple logistic regression analyses evaluated associations between full and subthreshold PTSD, and physical conditions.
A total 6.1% of the sample met screening criteria for full PTSD and 9.0% for subthreshold PTSD. Both full and subthreshold PTSD were associated with increased odds of sleep disorder (adjusted odds ratio [AOR] = 3.52 and 2.10, respectively) and respiratory conditions (AOR = 2.60 and 1.87, respectively). Full PTSD was additionally associated with increased odds of osteoporosis or osteopenia (AOR = 2.72) and migraine (AOR = 1.91), while subthreshold PTSD only was associated with increased odds of diabetes (AOR = 1.42). Analyses of PTSD symptom clusters revealed that all of these associations were primarily driven by dysphoric arousal symptoms, which are characterized by sleep difficulties, anger/irritability, and concentration problems.
The study used self-report measures for health conditions and DSM-IV diagnostic criteria for PTSD.
Results of this study provide a characterization of physical conditions associated with full and subthreshold PTSD in U.S. military veterans. They highlight the potential importance of PTSD dysphoric arousal in risk models of certain physical conditions in this population.
虽然完全型和亚阈值创伤后应激障碍（PTSD）都可能与身体状况有关，但关于军事退伍军人中这些关联的当代基于人群的数据却很稀少。此外，对于PTSD这一异质性疾病的各个组成方面如何与该人群的身体状况相关，人们知之甚少。
对参与2011年退伍军人全国健康与复原力研究的3157名美国军事退伍军人的基于人群的样本数据进行分析。多项逻辑回归分析评估了完全型和亚阈值PTSD与身体状况之间的关联。
样本中共有6.1%符合完全型PTSD的筛查标准，9.0%符合亚阈值PTSD的筛查标准。完全型和亚阈值PTSD都与睡眠障碍（调整后的优势比[AOR]分别为3.52和2.10）和呼吸系统疾病（AOR分别为2.60和1.87）的患病几率增加有关。完全型PTSD还与骨质疏松症或骨质减少症（AOR = 2.72）和偏头痛（AOR = 1.91）的患病几率增加有关，而仅亚阈值PTSD与糖尿病的患病几率增加有关（AOR = 1.42）。对PTSD症状群的分析表明，所有这些关联主要由烦躁不安的唤醒症状驱动，这些症状的特征是睡眠困难、愤怒/易怒和注意力不集中问题。
该研究使用自我报告的健康状况测量方法和PTSD的DSM-IV诊断标准。
本研究结果描述了与美国军事退伍军人中完全型和亚阈值PTSD相关的身体状况。它们突出了PTSD烦躁不安的唤醒在该人群某些身体状况风险模型中的潜在重要性。
