Post-traumatic stress disorder is associated with poor health behaviors: findings from the heart and soul study.
OBJECTIVE
Posttraumatic stress disorder (PTSD) results in substantial disability, including increased risk of cardiovascular disease (CVD). Poor health behaviors are major risk factors for initial and recurrent CVD events. Therefore, this study investigated whether PTSD is associated with poor health behaviors in patients with CVD.


METHODS
Cross-sectional study of 1,022 men and women with CVD. PTSD was assessed with the Computerized Diagnostic Interview Schedule for DSM-IV. Physical activity, medication adherence and smoking history were determined by self-report questionnaires. Multivariate logistic and linear regression models were used to evaluate the association of PTSD with health behaviors.


RESULTS
Of the 1,022 participants, 95 (9%) had PTSD. PTSD was associated with significantly higher rates of physical inactivity in terms of overall exercise (OR 1.6, 95% CI [1.0-2.6]; p = .049), light exercise (OR 1.7, 95% CI [1.0-2.9]; p = .045), and self-rated level of exercise compared to others of their age and sex (OR 1.8, 95% CI [1.0-3.0]; p = .047). Participants with PTSD were more likely to report medication nonadherence, including forgetting medications (OR 1.8, 95% CI [1.0-3.3]; p = .04) or skipping medications (OR 1.7, 95% CI [1.1-2.9]; p = .03). Participants with PTSD also reported a greater smoking history (β 6.4 pack years, 95% CI [1.8-10.9]; p = .006), which remained significant after adjustment for depression and income.


CONCLUSIONS
Among patients with heart disease, those with PTSD were more likely to report physical inactivity, medication nonadherence and smoking. The majority of these associations were explained by adjustment for comorbid depression and lower income.
Department of Medicine, University of California, Los Angeles, CA, USA.
Angelica L
AL
Zen
Mary A
MA
Whooley
Shoujun
S
Zhao
Beth E
BE
Cohen
D000368:Aged; D002318:Cardiovascular Diseases / Q000150:complications / Q000503:physiopathology / Q000523:psychology*; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires