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Psychobiologic predictors of disease mortality after psychological trauma: implications for research and clinical surveillance.
J Nerv Ment Dis. 2008 Feb; 196(2):100-7.JN

Abstract

Research has suggested that exposure to traumatic events can result in adverse health outcomes. However, the reasons for this are unclear. We examined psychobiologic factors associated with disease mortality among a community-based sample of 4462 male veterans 30 years after military service, including posttraumatic stress disorder (PTSD), erythrocyte sedimentation rate (ESR), white blood cell (WBC) count, and cortisol/dehydroepiandrosterone-sulfate (cortisol/DHEA-s) ratio. In the study, 56% (n = 2490) were theater veterans who served in Vietnam and 44% (n = 1972) era veterans who served elsewhere. During baseline in 1985, 10.2% of theater and 3.4% of era veterans had current PTSD. At follow-up in 2000, 13.6% of men with current baseline PTSD were deceased, compared with 5% without PTSD. Analyses suggested that having PTSD, a high ESR, a high WBC count, and a high cortisol/DHEA-s ratio at baseline were associated with all-cause disease mortality at follow-up. With the exception of cortisol/DHEA-s ratio, these factors also predicted cardiovascular mortality. Depression was not consistently associated with mortality, once other factors were controlled. Noteworthy was that having PTSD had an impact on mortality nearly comparable to common indicators of disease in medicine, such as an ESR >65 mm/h and a WBC count >11,000 mm(3). This study suggests that the morbidity associated with PTSD may be comparable to laboratory measures of disease pathology in common use and warrants further investigation and surveillance among at risk populations.

Authors+Show Affiliations

Geisinger Center for Health Research, Danville, Pennsylvania 17822, USA. jaboscarino@geisinger.edu

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18277217

Citation

Boscarino, Joseph A.. "Psychobiologic Predictors of Disease Mortality After Psychological Trauma: Implications for Research and Clinical Surveillance." The Journal of Nervous and Mental Disease, vol. 196, no. 2, 2008, pp. 100-7.
Boscarino JA. Psychobiologic predictors of disease mortality after psychological trauma: implications for research and clinical surveillance. J Nerv Ment Dis. 2008;196(2):100-7.
Boscarino, J. A. (2008). Psychobiologic predictors of disease mortality after psychological trauma: implications for research and clinical surveillance. The Journal of Nervous and Mental Disease, 196(2), 100-7. https://doi.org/10.1097/NMD.0b013e318162a9f5
Boscarino JA. Psychobiologic Predictors of Disease Mortality After Psychological Trauma: Implications for Research and Clinical Surveillance. J Nerv Ment Dis. 2008;196(2):100-7. PubMed PMID: 18277217.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Psychobiologic predictors of disease mortality after psychological trauma: implications for research and clinical surveillance. A1 - Boscarino,Joseph A, PY - 2008/2/16/pubmed PY - 2008/3/8/medline PY - 2008/2/16/entrez SP - 100 EP - 7 JF - The Journal of nervous and mental disease JO - J Nerv Ment Dis VL - 196 IS - 2 N2 - Research has suggested that exposure to traumatic events can result in adverse health outcomes. However, the reasons for this are unclear. We examined psychobiologic factors associated with disease mortality among a community-based sample of 4462 male veterans 30 years after military service, including posttraumatic stress disorder (PTSD), erythrocyte sedimentation rate (ESR), white blood cell (WBC) count, and cortisol/dehydroepiandrosterone-sulfate (cortisol/DHEA-s) ratio. In the study, 56% (n = 2490) were theater veterans who served in Vietnam and 44% (n = 1972) era veterans who served elsewhere. During baseline in 1985, 10.2% of theater and 3.4% of era veterans had current PTSD. At follow-up in 2000, 13.6% of men with current baseline PTSD were deceased, compared with 5% without PTSD. Analyses suggested that having PTSD, a high ESR, a high WBC count, and a high cortisol/DHEA-s ratio at baseline were associated with all-cause disease mortality at follow-up. With the exception of cortisol/DHEA-s ratio, these factors also predicted cardiovascular mortality. Depression was not consistently associated with mortality, once other factors were controlled. Noteworthy was that having PTSD had an impact on mortality nearly comparable to common indicators of disease in medicine, such as an ESR >65 mm/h and a WBC count >11,000 mm(3). This study suggests that the morbidity associated with PTSD may be comparable to laboratory measures of disease pathology in common use and warrants further investigation and surveillance among at risk populations. SN - 1539-736X UR - https://www.unboundmedicine.com/medline/citation/18277217/Psychobiologic_predictors_of_disease_mortality_after_psychological_trauma:_implications_for_research_and_clinical_surveillance_ L2 - https://doi.org/10.1097/NMD.0b013e318162a9f5 DB - PRIME DP - Unbound Medicine ER -