title: Metabolic syndrome: relative risk associated with post-traumatic stress disorder (PTSD) severity and antipsychotic medication use.
abstract: BACKGROUND
  In recent years, numerous lines of converging evidence have revealed an association between post-traumatic stress disorder (PTSD) and impaired physical health outcomes, including cardiovascular disease and metabolic syndrome. Although these findings have been interpreted as indicating a direct association of PTSD with metabolic syndrome and obesity, previous studies have not addressed the important confound of antipsychotic drug usage in this population. Second generation antipsychotic medications themselves are associated with metabolic syndrome and obesity, and it is unclear whether the common utilization of these drugs in PTSD may account for some if not all of the observed metabolic problems.
  
  
  OBJECTIVE
  The present study examined the relative contributions of PTSD severity and use of antipsychotic medications to risk of metabolic syndrome among veterans.
  
  
  METHODS
  Cross-sectional clinical data, including five factors representing metabolic syndrome, psychiatric diagnoses, and medications were gathered from 253 veterans enrolling in mental health services. We used a logistic regression model to measure the relative association of antipsychotic medication use and PTSD severity on risk of metabolic syndrome.
  
  
  RESULTS
  We found that antipsychotic medication usage was not uniquely associated with elevated risk of metabolic syndrome (Wald = 0.30, ns) when PTSD severity and other sociodemographic, psychiatric, and behavioral variables were accounted for. Furthermore, PTSD severity continued to be a significant and unique predictor of risk for metabolic syndrome (Wald = 4.04, p < 0.05).
  
  
  CONCLUSIONS
  These findings suggest that chronic and moderately severe PTSD, independent of antipsychotic medications, is associated with increased risk of metabolic syndrome.
authors.affiliation: Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA.
authors.forename: Pia S
authors.initials: PS
authors.lastname: Heppner
authors.forename: James B
authors.initials: JB
authors.lastname: Lohr
authors.forename: Taylor P
authors.initials: TP
authors.lastname: Kash
authors.forename: Hua
authors.initials: H
authors.lastname: Jin
authors.forename: Hongjun
authors.initials: H
authors.lastname: Wang
authors.forename: Dewleen G
authors.initials: DG
authors.lastname: Baker
mesh_terms: D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D056687:Off-Label Use; D012307:Risk Factors; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy / Q000453:epidemiology*; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*
chemical_list: D014150:Antipsychotic Agents