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Late-life health consequences of exposure to trauma in a general elderly population: the mediating role of reexperiencing posttraumatic symptoms.
J Clin Psychiatry. 2011 Jul; 72(7):929-35.JC

Abstract

OBJECTIVE

A history of trauma is associated with poor mental and physical health, but the specific impact of posttraumatic stress disorder (PTSD) symptoms on physical health using objective indicators of health status has rarely been evaluated in elderly civilians. This study investigates the long-term consequences of a lifetime exposure to trauma on health in a French elderly general population.

METHOD

Data from this retrospective study were derived from a longitudinal study (the Enquête de Santé Psychologique-Risques, Incidence et Traitement [ESPRIT]) of community-dwelling participants. Psychiatric health, medical history, and clinical examination (ICD-10 criteria) were assessed in 1,662 subjects (mean [SD] age = 72.5 [5.2] years). Lifetime traumatic exposure, PTSD, and psychiatric diagnoses were obtained using the Watson PTSD Inventory and the Mini-International Neuropsychiatric Interview. The outcome measures used were the Mini-International Neuropsychiatric Interview, Center for Epidemiologic Studies Depression Scale, Mini-Mental State Examination, and measures of physical health.

RESULTS

We observed an increase in the number and severity of health-related outcomes between groups, with nontraumatized subjects having the lowest risk and those with trauma leading to recurrent reexperiencing of events (nonresilient subjects) having the highest risk. Traumatized persons who did not report reexperiencing symptoms (resilient subjects) showed better current mental health than traumatized subjects who did and nontraumatized subjects. Nonresilient subjects were more likely to have current depressive symptoms (P = .003), current major depression (P < .0001), current anxiety disorder (P = .032), and psychiatric comorbidity (P = .002) than nontraumatized subjects. Resilient subjects differed from nontraumatized subjects in having significantly less current suicidal ideation (P = .054) and psychiatric comorbidity (P = .035). Both groups of traumatized subjects showed a higher rate of cardio-ischemic diseases, notably current angina pectoris (multivariate, adjusted OR = 2.27; 95% CI, 1.31-3.91; and OR = 2.34; 95% CI, 1.22-4.49; for resilient and nonresilient groups, respectively). Traumatized persons, specifically those nonresilient, showed a higher waist-hip ratio, higher triglyceride levels, and a greater frequency of hypertension.

CONCLUSIONS

Our findings suggest that trauma could be associated with cardio-ischemic diseases independently of PTSD symptoms expression. However, the presence of these symptoms appears associated with additional metabolic risk factors.

Authors+Show Affiliations

Inserm U888, Hôpital La Colombiére, pav. 42, 39 Avenue Charles Flahault, BP 34493, 34093 Montpellier Cedex 5, France. isabelle.chaudieu@inserm.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21824455

Citation

Chaudieu, Isabelle, et al. "Late-life Health Consequences of Exposure to Trauma in a General Elderly Population: the Mediating Role of Reexperiencing Posttraumatic Symptoms." The Journal of Clinical Psychiatry, vol. 72, no. 7, 2011, pp. 929-35.
Chaudieu I, Norton J, Ritchie K, et al. Late-life health consequences of exposure to trauma in a general elderly population: the mediating role of reexperiencing posttraumatic symptoms. J Clin Psychiatry. 2011;72(7):929-35.
Chaudieu, I., Norton, J., Ritchie, K., Birmes, P., Vaiva, G., & Ancelin, M. L. (2011). Late-life health consequences of exposure to trauma in a general elderly population: the mediating role of reexperiencing posttraumatic symptoms. The Journal of Clinical Psychiatry, 72(7), 929-35. https://doi.org/10.4088/JCP.10m06230
Chaudieu I, et al. Late-life Health Consequences of Exposure to Trauma in a General Elderly Population: the Mediating Role of Reexperiencing Posttraumatic Symptoms. J Clin Psychiatry. 2011;72(7):929-35. PubMed PMID: 21824455.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Late-life health consequences of exposure to trauma in a general elderly population: the mediating role of reexperiencing posttraumatic symptoms. AU - Chaudieu,Isabelle, AU - Norton,Joanna, AU - Ritchie,Karen, AU - Birmes,Philippe, AU - Vaiva,Guillaume, AU - Ancelin,Marie-Laure, PY - 2010/05/07/received PY - 2010/09/15/accepted PY - 2011/8/10/entrez PY - 2011/8/10/pubmed PY - 2011/10/1/medline SP - 929 EP - 35 JF - The Journal of clinical psychiatry JO - J Clin Psychiatry VL - 72 IS - 7 N2 - OBJECTIVE: A history of trauma is associated with poor mental and physical health, but the specific impact of posttraumatic stress disorder (PTSD) symptoms on physical health using objective indicators of health status has rarely been evaluated in elderly civilians. This study investigates the long-term consequences of a lifetime exposure to trauma on health in a French elderly general population. METHOD: Data from this retrospective study were derived from a longitudinal study (the Enquête de Santé Psychologique-Risques, Incidence et Traitement [ESPRIT]) of community-dwelling participants. Psychiatric health, medical history, and clinical examination (ICD-10 criteria) were assessed in 1,662 subjects (mean [SD] age = 72.5 [5.2] years). Lifetime traumatic exposure, PTSD, and psychiatric diagnoses were obtained using the Watson PTSD Inventory and the Mini-International Neuropsychiatric Interview. The outcome measures used were the Mini-International Neuropsychiatric Interview, Center for Epidemiologic Studies Depression Scale, Mini-Mental State Examination, and measures of physical health. RESULTS: We observed an increase in the number and severity of health-related outcomes between groups, with nontraumatized subjects having the lowest risk and those with trauma leading to recurrent reexperiencing of events (nonresilient subjects) having the highest risk. Traumatized persons who did not report reexperiencing symptoms (resilient subjects) showed better current mental health than traumatized subjects who did and nontraumatized subjects. Nonresilient subjects were more likely to have current depressive symptoms (P = .003), current major depression (P < .0001), current anxiety disorder (P = .032), and psychiatric comorbidity (P = .002) than nontraumatized subjects. Resilient subjects differed from nontraumatized subjects in having significantly less current suicidal ideation (P = .054) and psychiatric comorbidity (P = .035). Both groups of traumatized subjects showed a higher rate of cardio-ischemic diseases, notably current angina pectoris (multivariate, adjusted OR = 2.27; 95% CI, 1.31-3.91; and OR = 2.34; 95% CI, 1.22-4.49; for resilient and nonresilient groups, respectively). Traumatized persons, specifically those nonresilient, showed a higher waist-hip ratio, higher triglyceride levels, and a greater frequency of hypertension. CONCLUSIONS: Our findings suggest that trauma could be associated with cardio-ischemic diseases independently of PTSD symptoms expression. However, the presence of these symptoms appears associated with additional metabolic risk factors. SN - 1555-2101 UR - https://www.unboundmedicine.com/medline/citation/21824455/Late_life_health_consequences_of_exposure_to_trauma_in_a_general_elderly_population:_the_mediating_role_of_reexperiencing_posttraumatic_symptoms_ DB - PRIME DP - Unbound Medicine ER -