Journal Article

Associations between Lifetime Traumatic Events and Subsequent Chronic Physical Conditions: A Cross-National, Cross-Sectional Study

Murphy, Sam, Lim, Carmen C. W., Posada-Villa, Jose, Kessler, Ronald C., Bruffaerts, Ronny, Iwata, Noboru, Ormel, Johan, Koenen, Karestan C., Aguilar-Gaxiola, Sergio, Scott, Kate M., Caldas-de-Almeida, Jose Miguel, de Girolamo, Giovanni, Angermeyer, Matthias C., Levinson, Daphna, Alonso, Jordi, Benjet, Corina, Florescu, Silvia

2013

Overview

Associations between lifetime traumatic event (LTE) exposures and subsequent physical ill-health are well established but it has remained unclear whether these are explained by PTSD or other mental disorders. This study examined this question and investigated whether associations varied by type and number of LTEs, across physical condition outcomes, or across countries. Cross-sectional, face-to-face household surveys of adults (18+) were conducted in 14 countries (n = 38, 051). The Composite International Diagnostic Interview assessed lifetime LTEs and DSM-IV mental disorders. Chronic physical conditions were ascertained by self-report of physician's diagnosis and year of diagnosis or onset. Survival analyses estimated associations between the number and type of LTEs with the subsequent onset of 11 physical conditions, with and without adjustment for mental disorders. A dose-response association was found between increasing number of LTEs and odds of any physical condition onset (OR 1.5 [95% CI: 1.4-1.5] for 1 LTE; 2.1 [2.0-2.3] for 5+ LTEs), independent of all mental disorders. Associations did not vary greatly by type of LTE (except for combat and other war experience), nor across countries. A history of 1 LTE was associated with 7/11 of the physical conditions (ORs 1.3 [1.2-1.5] to 1.7 [1.4-2.0]) and a history of 5+ LTEs was associated with 9/11 physical conditions (ORs 1.8 [1.3-2.4] to 3.6 [2.0-6.5]), the exceptions being cancer and stroke. Traumatic events are associated with adverse downstream effects on physical health, independent of PTSD and other mental disorders. Although the associations are modest they have public health implications due to the high prevalence of traumatic events and the range of common physical conditions affected. The effects of traumatic stress are a concern for all medical professionals and researchers, not just mental health specialists.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adaptació (Psicologia) / Adaptation, Psychological - physiology / Adolescent / Adult / Adults / Analysis / Breast cancer / Cancer / Cardiovascular disease / Chronic illnesses / Cross-Sectional Studies / Diagnosis / Diagnostic systems / Eating disorders / Female / Health aspects / Health care policy / Health services / Humans / Logistic Models / Male / Mediation / Medical diagnosis / Medical personnel / Medical research / Medical societies / Mental disorders / Mental Health / Post traumatic stress disorder / Posttraumatic stress disorder / Psychology / Public health / Salut mental / Stress / Stress Disorders, Post-Traumatic - epidemiology / Stroke / Studies / Surveys / Trastorn per estrès posttraumàtic / Trauma / War / Young Adult