title: Disaster-related posttraumatic stress disorder and physical health.
abstract: OBJECTIVE
  To examine the relationship between posttraumatic stress disorder (PTSD) and self-reported as well as physician-recorded physical health in a sample of survivors (n = 896) of a man-made disaster, using a longitudinal design that included predisaster health data. Most studies on the relationship between PTSD and physical health are cross-sectional and use self-reported physical health outcomes.
  
  
  METHODS
  A surveillance using the electronic medical records of survivors' family practitioners (FPs), 1 year predisaster until 4 years postdisaster, was combined with a survey, 3 weeks and 18 months postdisaster. Self-reported PTSD and self-reported physical health were assessed at 18 months postdisaster. FP-recorded physical health problems in the subsequent 2 years were classified according to the International Classification of Primary Care. Multiple regression analyses were used to describe the relationships between PTSD and physical health.
  
  
  RESULTS
  After adjusting for demographics, smoking behavior, and predisaster physical health, PTSD was significantly associated with FP-recorded vascular, musculoskeletal, and dermatological problems, and with all self-reported physical health aspects. Prospectively, PTSD signaled an increased risk of new vascular problems (odds ratio = 1.92; 1.04-3.55).
  
  
  CONCLUSIONS
  This study suggests an effect of PTSD in the development of vascular problems. The results imply that clinicians should be alert that disaster survivors with PTSD can suffer from comorbid medical problems as well.
authors.affiliation: Netherlands Institute for Health Services Research, Utrecht, Netherlands. a.dirkzwager@nivel.nl
authors.forename: Anja J E
authors.initials: AJ
authors.lastname: Dirkzwager
authors.forename: Peter G
authors.initials: PG
authors.lastname: van der Velden
authors.forename: Linda
authors.initials: L
authors.lastname: Grievink
authors.forename: C Joris
authors.initials: CJ
authors.lastname: Yzermans
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004190:Disasters; D005260:Female; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000150:complications* / Q000523:psychology*; D017741:Survivors / Q000523:psychology; D014652:Vascular Diseases / Q000453:epidemiology / Q000209:etiology