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

被引：117

作者：

Scott, Kate M. ^{[1
]}

Koenen, Karestan C. ^{[2
]}

Aguilar-Gaxiola, Sergio ^{[3
]}

Alonso, Jordi ^{[4
,5
]}

Angermeyer, Matthias C. ^{[6
]}

Benjet, Corina ^{[7
]}

Bruffaerts, Ronny ^{[8
]}

Caldas-de-Almeida, Jose Miguel ^{[9
,10
]}

de Girolamo, Giovanni ^{[11
]}

Florescu, Silvia ^{[12
]}

Iwata, Noboru ^{[13
]}

Levinson, Daphna ^{[14
]}

Lim, Carmen C. W. ^{[15
]}

Murphy, Sam ^{[16
]}

Ormel, Johan ^{[17
]}

Posada-Villa, Jose ^{[18
]}

Kessler, Ronald C. ^{[19
]}

机构：

[1] Univ Otago, Dept Psychol Med, Dunedin, New Zealand

[2] Columbia Mailman Sch Publ Hlth, New York, NY USA

[3] Univ Calif Davis, Sch Med, Ctr Reducing Hlth Dispar, Community Engagement Program,Clin Translat Sci Ct, Sacramento, CA 95817 USA

[4] Hosp del Mar, Hlth Serv Res Unit, Inst Municipal Invest Med, Barcelona, Spain

[5] CIBER Epidemiol & Salud Publ CIBERESP, Barcelona, Spain

[6] Ctr Publ Mental Hlth, Gosing Wagram, Austria

[7] Natl Inst Psychiat Ramon de la Fuente, Dept Epidemiol & Psychosocial Res, Mexico City, DF, Mexico

[8] Univ Psychiat Ctr Katholieke Univ Leuven, Louvain, Belgium

[9] Univ Nova Lisboa, Fac Ciencias Med, Chron Dis Res Ctr CEDOC, P-1200 Lisbon, Portugal

[10] Univ Nova Lisboa, Fac Ciencias Med, Dept Mental Hlth, P-1200 Lisbon, Portugal

[11] IRCCS, Ctr S Giovanni di Dio Fatebenefratelli, Brescia, Italy

[12] Natl Sch Publ Hlth Management & Profess Dev, Bucharest, Romania

[13] Hiroshima Int Univ, Fac Psychol Sci, Dept Clin Psychol, Hiroshima, Japan

[14] Minist Hlth, Mental Hlth Serv, Jerusalem, Israel

[15] Univ Otago, Dept Psychol Med, Dunedin, New Zealand

[16] Univ Ulster, Sch Psychol, Psychol Res Inst, Coleraine BT52 1SA, Londonderry, North Ireland

[17] Univ Groningen, Univ Med Ctr Groningen, Groningen, Netherlands

[18] Cundinamarca Univ, Colegio Mayor, Bogota, DC, Colombia

[19] Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA

来源：

PLOS ONE | 2013年 / 8卷 / 11期

关键词：

POSTTRAUMATIC-STRESS-DISORDER; CHILDHOOD MALTREATMENT; MENTAL-DISORDERS; PRIMARY-CARE; EPIDEMIOLOGIC SURVEY; COMORBIDITY SURVEY; HEALTH CONDITIONS; CANCER INCIDENCE; MULTIPLE TRAUMA; BREAST-CANCER;

D O I：

10.1371/journal.pone.0080573

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Background: 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. Methods: 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. Findings: 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. Conclusions: 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.

引用

页数：11

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