The link between post-traumatic stress disorder and physical comorbidities: a systematic review.
BACKGROUND
Returning veterans from Afghanistan and Iraq will increase frequency of post-traumatic stress disorder (PTSD). Little is known about its impact on physical health.


OBJECTIVE
Systematic literature review focusing on the association between PTSD and specific physical disorders.


METHODS
An electronic search using PUBMED and hand search of four journals with an anxiety focus for studies published between January 1981 and July 2008, plus a manual search of article bibliographies.


METHODS
Original research reports focusing on PTSD and its association with physical health. Studies investigating only PTSD symptoms, trauma and physical disorders classified at the organ-system level were excluded. Eighty studies were reviewed and seven selected for final analysis.


METHODS
Specific physical-health diagnoses were organized by system and tabulated. They were considered positive only if results were statistically significant. Total number of positive and negative studies for each diagnosis was then calculated for review.


RESULTS
Seven studies examined the relationship between PTSD and specific physical disorders. Arthritis was associated with PTSD in most studies. Data conflicted regarding diabetes, coronary heart disease, and stroke.


CONCLUSIONS
Few studies have examined the relationship between PTSD and physical health. Large, prospective epidemiological trials are needed.
Qureshi
Salah U
SU
Houston Center for Quality of Care & Utilization Studies, Health Services Research and Development Service, Michael E. DeBakey Veterans Affairs Medical Center (152), 2002 Holcombe, Houston, TX, 77030, USA.
Pyne
Jeffrey M
JM
Magruder
Kathy M
KM
Schulz
Paul E
PE
Kunik
Mark E
ME
D000328:Adult; D001168:Arthritis / Q000453:epidemiology*; D015897:Comorbidity; D003327:Coronary Disease / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000453:epidemiology*; D006801:Humans; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology; D020521:Stroke / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000523:psychology*