Physical Illness and PTSD appear to be linked
Posted by defensebaseactcomp on December 30, 2011
Among responders to the World Trade Center disaster, there appears to be a relationship between respiratory problems and posttraumatic stress disorder (PTSD), researchers found. In a statistical model, PTSD mediated the association between exposure at the site and respiratory symptoms among both police officers and other types of responders, Evelyn Bromet, PhD, of Stony Brook University in New York, and colleagues reported online in Psychological Medicine. The results suggest “an indirect association of exposure with respiratory symptoms through PTSD, a finding that mirrors research conducted with Vietnam veterans,” the researchers wrote.
Respiratory illness and PTSD are both signature health problems among rescue workers who responded to the World Trade Center on Sept. 11, 2001, but the relationship between the two conditions isn’t clear.
So Bromet and her colleagues assessed 8,508 police officers and 12,333 other types of responders who were evaluated at the World Trade Center Medical Monitoring and Treatment Program between July 16, 2002, and Sept. 11, 2008.
They used structural equation modeling (SEM) to explore patterns of association between exposures and other risk factors.
Overall, fewer police than other responders had probable PTSD (5.9% versus 23%) and respiratory symptoms (22.5% versus 28.4%), although pulmonary function was similar between the two groups.
They found that PTSD and respiratory symptoms were moderately correlated for both groups (r=0.28 for police and 0.27 for other responders).
Exposure was more strongly associated with respiratory symptoms (r=0.14 to 0.24), and showed less of an association with probable PTSD (r=0.07 to 0.12). Exposure was only weakly associated with lung function, they reported.
Regarding the SEM models, Bromet and colleagues found that those in which the association between exposure and respiratory problems were mediated in part by PTSD showed a “better absolute fit” in both groups of responders, leading them to conclude that the association between exposure and respiratory symptoms may be mediated through PTSD.
It may be that PTSD, which is associated with immunologic function, can increase pulmonary inflammation, resulting in respiratory abnormalities, or the cognitive processes associated with the condition can increase the perception of respiratory symptoms, they wrote.
On the other hand, chronic respiratory symptoms could serve as reminders of traumatic events and increase PTSD rates, they wrote.
Further longitudinal studies are needed to disentangle the possibilities, they said