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Biol Psychiatry. 2014 Jun 28. pii: S0006-3223(14)00457-0. doi: 10.1016/j.biopsych.2014.06.015. [Epub ahead of print]

Elevated Risk for Autoimmune Disorders in Iraq and Afghanistan Veterans with Posttraumatic Stress Disorder.

Author information

  • 1University of California, San Francisco, California; San Francisco Veterans Affairs Medical Center and Northern California Institute for Research and Education, San Francisco, California. Electronic address: aoife.odonovan@ucsf.edu.
  • 2University of California, San Francisco, California; San Francisco Veterans Affairs Medical Center and Northern California Institute for Research and Education, San Francisco, California.
  • 3San Francisco Veterans Affairs Medical Center and Northern California Institute for Research and Education, San Francisco, California.
  • 4University of California, San Francisco, California.

Abstract

BACKGROUND:

Posttraumatic stress disorder (PTSD) is associated with endocrine and immune abnormalities that could increase risk for autoimmune disorders. However, little is known about the risk for autoimmune disorders among individuals with PTSD.

METHODS:

We conducted a retrospective cohort study of 666,269 Iraq and Afghanistan veterans under age 55 who were enrolled in the Department of Veterans Affairs health care system between October 7, 2001, and March 31, 2011. Generalized linear models were used to examine if PTSD, other psychiatric disorders, and military sexual trauma exposure increased risk for autoimmune disorders, including thyroiditis, inflammatory bowel disease, rheumatoid arthritis, multiple sclerosis, and lupus erythematosus, adjusting for age, gender, race, and primary care visits.

RESULTS:

PTSD was diagnosed in 203,766 veterans (30.6%), and psychiatric disorders other than PTSD were diagnosed in an additional 129,704 veterans (19.5%). Veterans diagnosed with PTSD had significantly higher adjusted relative risk (ARR) for diagnosis with any of the autoimmune disorders alone or in combination compared with veterans with no psychiatric diagnoses (ARR = 2.00; 95% confidence interval, 1.91-2.09) and compared with veterans diagnosed with psychiatric disorders other than PTSD (ARR = 1.51; 95% confidence interval, 1.43-1.59; p < .001). The magnitude of the PTSD-related increase in risk for autoimmune disorders was similar in women and men, and military sexual trauma exposure was independently associated with increased risk in both women and men.

CONCLUSIONS:

Trauma exposure and PTSD may increase risk for autoimmune disorders. Altered immune function, lifestyle factors, or shared etiology may underlie this association.

Copyright © 2014 Society of Biological Psychiatry. All rights reserved.

KEYWORDS:

Autoimmune disorders; glucocorticoids; immune system; inflammation; military sexual trauma; posttraumatic stress disorder; traumatic stress; veterans

PMID:
25104173
[PubMed - as supplied by publisher]
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