HealthDay News – Posttraumatic stress disorder (PTSD) symptomatology is associated with an increased incident risk of rheumatoid arthritis (RA) in women, according to a study published in the March issue of Arthritis Care & Research.1

Yvonne C. Lee, MD, from Harvard Medical School in Boston, and colleagues examined the correlation between PTSD symptoms and RA risk in a subset of 54,224 participants of the Nurses’ Health Study II. Participants completed the Brief Trauma Questionnaire and a screen for PTSD symptoms and were classified according to trauma exposure and number of PTSD symptoms.

From 1989 to 2011, 239 incident RA cases were identified. The researchers found that in models adjusted for age, race, and socioeconomic status, the hazard ratio for four or more PTSD symptoms and incident RA was 1.76, compared to no history of trauma/PTSD symptoms. There was an increase in the risk for RA with increasing number of PTSD symptoms (P = 0.01). The hazard ratio for RA remained elevated (1.60) when smoking was added to the model. The correlation persisted in a subgroup analysis excluding women who smoked before PTSD onset (hazard ratio, 1.68).


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“Further studies are necessary to examine the role of other behaviors and clinical characteristics, such as alcohol consumption and obesity, as potential confounders and/or mediators of the association between PTSD and risk for RA,” the authors write.


Summary and Clinical Applicability

PTSD develops following the exposure to an event resulting in marked psychological trauma. There have been studies on veterans experiencing PTSD that suggest that they may be disproportionately affected by chronic illnesses, including cardiovascular disease, diabetes mellitus, psoriasis, and RA.2   

In this study, women with PTSD symptomatology were shown to be at an increased risk of developing RA.1  This risk was independent of any risk associated with smoking.  It is important to note, however, that this study did not prove causality as the data retrieved on PTSD symptom onset was collected retrospectively. 

Studies like these highlight the role of stress and psychological factors as determinants for chronic diseases like RA. 

Reference

1. Lee YC, Agnew-blais J, Malspeis S, et al. Post-Traumatic Stress Disorder and Risk for Incident Rheumatoid Arthritis. Arthritis Care Res (Hoboken). 2016;68(3):292-8.

2. Boscarino JA. Posttraumatic stress disorder and physical illness: results from clinical and epidemiologic studies. Ann N Y Acad Sci. 2004; 1032: 141–53.