According to the article, posttraumatic stress disorder (PTSD) is a psychiatric disorder characterized by avoidance behaviors and interpersonal difficulties that can occur following experiencing or witnessing a life-threatening or particularly traumatic event, such as terrorism, rape or physical assault. Patients with depression and posttraumatic stress disorder make up about 12 percent of primary care patients, and depression has been linked with poor health, the article states. However, the association between PTSD and physical illness in women is poorly understood.
Susan M. Frayne, M.D., M.P.H., from the Veterans Affairs Palo Alto Health Care System, Menlo Park, Calif., and colleagues compared the number of medical symptoms and health status of women with PTSD (n=4,348; average age, 45.7 years), women with depression alone (n=7,580; average age, 50.2 years), and women without depression or PTSD (n=18,937; average age, 53.2 years).
The researchers found that among women younger than 45 years, 17 percent had a reported history of PTSD, and 25 percent had a reported history of depression. Among women aged 45 to 64 years, 17 percent had PTSD, and 28 percent had depression; and among women 65 years or older, 4 percent had PTSD, and 20 percent had depression.
Across all ages, women with PTSD had more medical conditions and worse physical health status (poor physical functioning, role limitations due to physical problems, pain, low energy) than women with depression alone, or neither depression nor PTSD, report the researchers.
"Posttraumatic stress disorder is associated with a greater burden of medical illness than is seen with depression alone," write the authors. "The presence of PTSD may account for an important component of the excess medical morbidity and functional status limitations seen in women with depression."
(Arch Intern Med. 2004;164:1306-1312. Available post-embargo at archinternmed.com)
Editor's Note: Work for this article was financially supported by the Veterans Health Administration through the Office of Public Health and Environmental Hazards, and by a Department of Veterans Affairs Health Services Research and Development grant. Data used in this article were originally collected as part of the 1999 Large Health Survey of Veteran Enrollees, funded by the Department of Veterans Affairs Office for Quality and Performance.
To contact Susan M. Frayne, M.D., M.P.H., call Kerri Childress at 650-858-3925.
For more information, contact JAMA/Archives Media Relations at 312-464-JAMA (5262) or e-mail mediarelations@jama-archives.org .
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Archives of Internal Medicine