Women with the most symptoms of posttraumatic stress disorder (PTSD) appear to have a nearly two-fold increased risk of developing type 2 diabetes mellitus (T2D) compared to women not exposed to trauma, according to a study published online by JAMA Psychiatry.
PTSD can occur following a potentially traumatic life event and prior research has suggested an association between PTSD and T2D. But it was unclear from those studies whether PTSD increased the risk of T2D, whether T2D increased the risk of PTSD or whether the conditions were associated because of other factors, according to the study background.
Andrea L. Roberts, PhD., of the Harvard School of Public Health, Boston, and coauthors conducted one of the first longitudinal studies of PTSD and the incidence of T2D in a civilian group of women. The authors used the Nurses' Health Study II (N=49,739) to examine the association between PTSD symptoms and the incidence of T2D over a 22-year follow-up period.
During the follow-up, 3,091 of the 49,739 women (6.2 percent) developed T2D. Women with PTSD symptoms had a higher incidence of T2D than women who were not exposed to a traumatic event. For example, there were 4.6 cases of T2D per 1,000 person-years among women with six or seven PTSD symptoms; 3.9 cases among women with four to five symptoms; 3.7 cases among women with one to three symptoms; 2.8 cases among women exposed to trauma but with no PTSD symptoms; and 2.1 cases among women unexposed to trauma, according to the results.
Study results indicate that antidepressant use and a higher body mass index associated with PTSD accounted for nearly half of the increased risk of T2D for women with PTSD. Among the study population, smoking, diet quality, alcohol intake and physical activity did not further account for the increased risk of T2D for women with PTSD.
"Our findings have implications for research and practice. Further research must identify the biochemical and possible additional behavioral changes, such as sleep disturbance, that mediate the relationship between PTSD and onset of T2D. A better understanding of pathways will facilitate interventions to prevent this disabling disease," the study concludes.
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(JAMA Psychiatry. Published online January 7, 2015. doi:10.1001/jamapsychiatry.2014.2632. Available pre-embargo to the media at http://media.jamanetwork.com.)
Editor's Note: Authors made funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Media Advisory: To contact corresponding author Karestan C. Koenen, Ph.D., call Stephanie Berger at 212-305-4372 or email sb2247@columbia.edu.
Journal
JAMA Psychiatry