Can traumatic events trigger physical disorders? Depress Anxiety.May.2013.

29.07.2013

Violence, injury, and disaster are common traumatic events with significant mental health consequences. Would  such traumatic experiences diminish physical health as well ?  Trauma can indirectly affect physical health via  changes in smoking/ alcohol use/physical inactivity and depression.Stress and trauma can trigger various physiological changes directly and it is likely that physical health  can be affected  by such changes.Cumulative effect of  potentially traumatic stressors on physical health outcomes remain understudied.

Katherine M. Keyes and team of researchers from New york, Michigan and Boston attempt to answer this question using data from Detroit Neighborhood Health Study. More than 1000 individuals were interviewed in two stages one year apart. Interview (wave 1) collected data on potentially traumatic events (PTE). Physical health indicators were retrospectively assessed at Wave 2.

Findings:

Sudden unexpected death of a loved one was the most prevalent PTE, with 70 % of the sample reporting exposure at some point in the life course .15% of the sample reported no PTEs, and 20 % of respondents reported eight or more PTEs in their lifetime. Common physical health conditions in the sample included cardiovascular disease (45%) and arthritis (31%).

Those  who experienced a PTE were at significantly increased risk for an earlier diagnosis of a physical health condition.  Respondents with the highest levels of PTE (8+ events) had an average age of physical condition onset that was 15 years earlier than respondents with no exposure. Dose–response relation was significant between the number of events experienced across the life course and arthritis risk. This remained so after controlling for psychiatric morbidity and health behaviors .

Trauma exposure, independent of PTSD, has deleterious consequences on physical health. Stressful experiences may exacerbate inflammatory responses and this is a possible mechanism.Traumas involving assault and other violent events are more related to arthritis . It is possible that the injury lead to  changes in joint functioning and then arthritis sets in. Study did not find strong associations between PTE exposure and cardiovascular disease once models were adjusted for health behaviors and co-occurring disorders.

Limitations

Both PTE exposure and physical health outcomes were self- reported in these data (self report bias).Alcohol use was assessed in the past month rather than lifetime, and dietary health, exercise, and BMI were not assessed.

Conclusions:

Traumatic events are common contributors to mental and physical disorders.The study show robust associations between potentially traumatic experiences, such as violence and injury with the development of arthritis.

Summary of the article:

Potentially traumatic events and the risk of six physical health conditions in a population-based sample.

Keyes KM, McLaughlin KA, Demmer RT, Cerdá M, Koenen KC, Uddin M, Galea S. Depress Anxiety. 2013 May;30(5):451-60

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