San Francisco Veterans Affairs Health Care System, 4150 Clement Street, San Francisco, CA, 94121, USA.
Department of Internal Medicine, University of California San Francisco, San Francisco, CA, USA.
Curr Psychiatry Rep. 2018 Oct 26;20(12):116. doi: 10.1007/s11920-018-0977-9.
We review evidence linking PTSD to physical health symptoms and specific disorders, highlighting areas with multiple studies and objective measures of disease states when available. We also examine evidence for biological, behavioral, and psychosocial mechanisms underlying these associations and discuss the clinical implications of recent research.
Recent meta-analyses have found that evidence is particularly strong for increased risk of cardiovascular, metabolic, and musculoskeletal disorders among patients with PTSD. Numerous studies have found alterations in the hypothalamic-pituitary-adrenal axis, sympathetic nervous system, inflammation, and health behaviors that could increase risk of illness, but few studies have simultaneously incorporated measures of mechanisms and disease outcomes. Future research should focus on expanding the diversity of populations studied, particularly with respect to underrepresented racial and ethnic groups. Longitudinal studies that incorporate repeated measures of PTSD, pathogenic mechanisms of disease, and physical health outcomes and the addition of physical health outcomes to PTSD treatment trials will be most informative for the field.
我们回顾了 PTSD 与身体健康症状和特定疾病之间关联的证据，重点介绍了有多项研究和疾病状态客观测量的领域。我们还探讨了这些关联背后的生物学、行为和心理社会机制的证据，并讨论了最近研究的临床意义。
最近的荟萃分析发现，PTSD 患者患心血管、代谢和肌肉骨骼疾病的风险增加的证据特别强。许多研究发现，下丘脑-垂体-肾上腺轴、交感神经系统、炎症和健康行为的改变可能会增加患病风险，但很少有研究同时纳入了机制和疾病结果的测量。未来的研究应侧重于扩大研究人群的多样性，特别是代表性不足的种族和族裔群体。将 PTSD、疾病发病机制和身体健康结果的重复测量以及将身体健康结果纳入 PTSD 治疗试验的纵向研究将为该领域提供最有价值的信息。
