title: Biological and psychological predictors of posttraumatic stress disorder onset and chronicity. A one-year prospective study.
abstract: BACKGROUND
  Few studies have prospectively examined risk factors for posttraumatic stress disorder (PTSD) in the aftermath of a traumatic exposure. The aim of this study is to identify the concurrent influence of psychological and biological diatheses on PTSD onset and maintenance, taking into account socio-demographic factors and psychiatric antecedents.
  
  
  METHODS
  A total of 123 civilians (61.8% of women) recruited in emergency units, were assessed using validated instruments during the first week and then at 1, 4, and 12 months post-trauma. Baseline assessment included evaluation of the psychological diathesis (i.e. psychiatric history and peritraumatic distress and dissociation), and the biological diathesis [i.e. cortisol, norepinephrine, epinephrine, c-reactive protein, total cholesterol, HDL cholesterol, glycosylated haemoglobin, waist-to-hip ratio (WHR), body mass index, diastolic and systolic blood pressure (SBP), and heart rate].
  
  
  RESULTS
  Multivariate logistic regression analyses demonstrated both psychological and biological diatheses to be independent risk factors for PTSD. Peritraumatic distress and dissociation predicted onset (1-month) and mid-term PTSD (4-months), respectively. PTSD risk was associated positively with SBP and negatively with WHR, throughout the follow-up. In addition, a higher level of 12 h-overnight urinary norepinephrine independently predicted mid-term PTSD (4-months).
  
  
  CONCLUSIONS
  This prospective study shows that peritraumatic psychological and biological markers are independent predictors of PTSD onset with specificities according to the stage of PTSD development; the psychological diathesis, i.e. peritraumatic distress and dissociation, being a better predictor of short-term dysfunction whereas biological diathesis was also predictive of development and maintenance of PTSD.
authors.affiliation: Inserm, U1061, Montpellier, F-34093, France; Université Montpellier, Montpellier, F-34000, France.
authors.forename: C
authors.initials: C
authors.lastname: Gandubert
authors.affiliation: Inserm, U1061, Montpellier, F-34093, France; Université Montpellier, Montpellier, F-34000, France.
authors.forename: J
authors.initials: J
authors.lastname: Scali
authors.affiliation: Inserm, U1061, Montpellier, F-34093, France; Université Montpellier, Montpellier, F-34000, France.
authors.forename: M-L
authors.initials: ML
authors.lastname: Ancelin
authors.affiliation: Inserm, U1061, Montpellier, F-34093, France; Université Montpellier, Montpellier, F-34000, France.
authors.forename: I
authors.initials: I
authors.lastname: Carrière
authors.affiliation: Inserm, U1061, Montpellier, F-34093, France; CHU Montpellier, Department of Biochemistry A, F-34000, France.
authors.forename: A-M
authors.initials: AM
authors.lastname: Dupuy
authors.affiliation: Inserm, U1061, Montpellier, F-34093, France; Université Montpellier, Montpellier, F-34000, France.
authors.forename: G
authors.initials: G
authors.lastname: Bagnolini
authors.affiliation: Inserm, U1061, Montpellier, F-34093, France; Université Montpellier, Montpellier, F-34000, France; Neuroepidemiology, Imperial College, London, United Kingdom.
authors.forename: K
authors.initials: K
authors.lastname: Ritchie
authors.affiliation: Université Montpellier, Montpellier, F-34000, France; CHU Montpellier, Department of Emergency, F-34000, France.
authors.forename: M
authors.initials: M
authors.lastname: Sebanne
authors.affiliation: Université Montpellier, Montpellier, F-34000, France; CHU Montpellier, Department of Forensic Medicine, F-34000, France.
authors.forename: L
authors.initials: L
authors.lastname: Martrille
authors.affiliation: Université Montpellier, Montpellier, F-34000, France; CHU Montpellier, Department of Forensic Medicine, F-34000, France.
authors.forename: E
authors.initials: E
authors.lastname: Baccino
authors.affiliation: Université Montpellier, Montpellier, F-34000, France; CHU Montpellier, Department of Adult Psychiatry, F-34000, France.
authors.forename: A
authors.initials: A
authors.lastname: Hermès
authors.affiliation: Inserm, U1061, Montpellier, F-34093, France; Université Montpellier, Montpellier, F-34000, France; CHU Montpellier, Department of Adult Psychiatry, F-34000, France.
authors.forename: J
authors.initials: J
authors.lastname: Attal
authors.affiliation: Inserm, U1061, Montpellier, F-34093, France; Université Montpellier, Montpellier, F-34000, France.
authors.forename: I
authors.initials: I
authors.lastname: Chaudieu
keywords: Cortisol; Norepinephrine; PTSD; Peritraumatic reaction; Waist-to-hip-ratio