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PTSD linked to subsequent autoimmune disorders

Patients with PTSD had a significantly higher risk for an autoimmune disorder, according to findings recently published in JAMA.

“Epidemiological evidence underpinning the association between stress-relateddisorders and autoimmune diseases in humans is limited,” Huan Song, MD, PhD, of the Center of Public Health Sciences at the University of Iceland, and colleagues wrote. “Existing data are largely based on male, military samples focusing on PTSD instead of all clinically confirmed, stress-related disorders. Further limitations entail cross-sectional designs, small sample sizes, and incomplete control of familial factors.”

Researchers matched 106,464 patients with stress-related disorders in a 1:10 ratio with patients who did not have such a disorder to determine their risk for an autoimmune disorder. The latter group also had 126,652 siblings whose autoimmune disorder history was considered. Patients were followed for a mean of 10 years.

Song and colleagues found that patients with stress-related disorders were at higher risk for autoimmune disease (HR = 1.36; 95% CI, 1.33-1.4) vs. those without a stress-related disorder. HR for patients with PTSD was 1.46 (95% CI, 1.32-1.61) for any autoimmune disorder and 2.29 (95% CI, 1.72-3.04) for three or more autoimmune diseases. These links remained consistent when compared with their siblings.

In addition, in patients aged 33 years and younger, RR elevations were more pronounced (HR = 1.48, 95% CI, 1.42-1.55). In those patients aged 34 to 41 years, HR was 1.41 (95% CI, 1.33-1.48); in patients aged 42 to 50 years, HR was 1.31 (95% CI, 1.24-1.37) and in patients aged at least 51 years, HR was 1.23 (95% CI, 1.17-1.3). However, the longer a selective serotonin uptake inhibitor was taken, the lower the patient’s RR for an autoimmune disease.

“To our knowledge, this is the first study to address all stress-related disorders and their associations with 41 distinct autoimmune diseases in men and women using both population- and sibling-based comparisons,” Song and colleagues wrote.

“Although the present findings are of etiologic importance, the relatively modest differences in incidence rates of autoimmune disease between the exposed and unexposed individuals (9.1 and 6 per 1,000 person-years, respectively) do not provide direct evidence for altered clinical management or monitoring of persons with stress-related disorders,” they wrote. – by Janel Miller

Disclosures : Song reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.