Underner Michel, Goutaudier Nelly, Peiffer Gérard, Perriot Jean, Harika-Germaneau Ghina, Jaafari Nematollah
Université de Poitiers, centre hospitalier Henri-Laborit, unité de recherche clinique, 86021 Poitiers, France.
Université de Poitiers, centre de recherches sur la cognition et l'apprentissage, UMR CNRS 7295 MSHS, 86073 Poitiers cedex 9, France.
Presse Med. 2019 May;48(5):488-502. doi: 10.1016/j.lpm.2019.03.002. Epub 2019 Apr 17.
Exposure to a traumatic event may not only lead to a large variety of mental disorders, such as post-traumatic stress disorder (PTSD) but also respiratory symptoms and/or respiratory diseases, as asthma.
Systematic literature review of data on the impact of post-traumatic stress disorder on asthma.
Medline, on the period 1980-2018 with the following keywords: "PTSD" or "post-traumatic stress disorder" or "post-traumatic stress disorder" and "asthma", limits "title/abstract"; the selected languages were English or French. Among 141 articles, 23 abstracts have given use to a dual reading to select 14 studies.
While PTSD may develop 4 weeks after being exposed to a traumatic event during which the physical integrity of the person has been threatened, it might also develop several months or years later. PTSD has been reported to be a risk factor for asthma and also a factor that might enhance a preexisting asthma. It is also important to note that this relation has been highlighted among several populations, traumatic events and regardless the gender and/or cultural factors. Despite its impact on the development of asthma, in asthmatic patients, PTSD may be responsible for poor asthma control, increased rates of healthcare use (visit in the emergency department and/or hospitalization for asthma) and poor asthma-related quality of life. The study of the association between PTSD and asthma have to take into account some potentially confounding factors, such as smoking status and dust exposure (e.g.: asthma following the terrorist attacks of the World Trade Center). Less is known regarding the potential mechanisms involved in the association between PTSD and asthma. Several factors including the nervous system, the hypothalamo-pituitary-adrenal axis, the inflammatory response and the immune system may explain the association.
PTSD is a risk factor for the development of asthma and for the worsening of preexisting asthma. In asthmatic patients, it is of primary importance to systematically screen potential PTSD that might be developed after a traumatic event or a preexisting traumatic condition. Moreover, after exposure to a traumatic event, a special attention needs to be paid to somatic reactions such as asthma. The majority of studies having been conducted on American samples, replicating studies among European samples appears of prime importance in order to add a body of knowledge on the association between somatic and psychiatric conditions.
遭受创伤性事件不仅可能导致多种精神障碍，如创伤后应激障碍（PTSD），还可能引发呼吸症状和/或呼吸系统疾病，如哮喘。
对创伤后应激障碍对哮喘影响的数据进行系统文献综述。
检索1980 - 2018年期间的Medline数据库，使用以下关键词：“PTSD”或“创伤后应激障碍”或“创伤后应激障碍”和“哮喘”，限定检索范围为“标题/摘要”；所选语言为英语或法语。在141篇文章中，23篇摘要经双人阅读筛选出14项研究。
PTSD可能在遭受威胁人身安全的创伤性事件4周后出现，也可能在数月或数年后出现。据报道，PTSD是哮喘的一个危险因素，也是可能加重已患哮喘的一个因素。同样重要的是要注意，这种关系在多个群体、创伤性事件中均有体现，且不受性别和/或文化因素影响。尽管PTSD对哮喘的发展有影响，但在哮喘患者中，PTSD可能导致哮喘控制不佳、医疗保健使用率增加（因哮喘到急诊科就诊和/或住院）以及哮喘相关生活质量较差。对PTSD与哮喘之间关联的研究必须考虑一些潜在的混杂因素，如吸烟状况和接触粉尘情况（例如：世贸中心恐怖袭击后的哮喘）。关于PTSD与哮喘之间关联的潜在机制，人们了解较少。包括神经系统、下丘脑 - 垂体 - 肾上腺轴、炎症反应和免疫系统在内的几个因素可能解释这种关联。
PTSD是哮喘发生和已患哮喘病情恶化的危险因素。在哮喘患者中，系统筛查创伤性事件后可能出现的潜在PTSD或既往存在的创伤情况至关重要。此外，在遭受创伤性事件后，需要特别关注诸如哮喘等躯体反应。大多数研究以美国样本为对象，因此在欧洲样本中重复进行研究对于增加关于躯体疾病和精神疾病之间关联的知识体系显得尤为重要。
