Post-Traumatic Stress Disorder and its Somatic Comorbidities: A Review
DOI:
https://doi.org/10.12775/JEHS.2025.80.59387Keywords
Post-Traumatic Stress Disorder (PTSD), cardiovascular diseases, metabolic diseases, inflammation, autoimmune diseasesAbstract
As of today, research has shown that exposure to traumatic events and psychological trauma is a widespread phenomenon. Its association with PTSD and other various mental disorders has been widely studied. However, research suggests the exposure to such events is said to be correlated with early onset of specific diseases, increased healthcare utilization, and premature death. The aim of this review is to summarize the available literature and explore various diseases and their relations to PTSD. The areas of interest for this particular review will include cardiovascular, metabolic, and autoimmune diseases as well as inflammation. Ample evidence of the link between PTSD and somatic diseases (specifically cardiovascular, metabolic, and autoimmune disease as well as additional comorbidities that do not fit into either category) following it is presented, as well as some additional studies showing bidirectional relationships between PTSD and several illnesses. Several other notable comorbidities are discussed as well, followed by a brief overview of presented studies and their limitations as well as a conclusion. Last presented is a list of potential future research directions, followed by a generalized discussion of the review at hand. A strong recommendation for rigorous implementation of trauma-informed care in healthcare facilities is presented, along with research corroborating the need for such practice.
References
Allgire, E., McAlees, J. W., Lewkowich, I. P., & Sah, R. (2021). Asthma and posttraumatic stress disorder (PTSD): emerging links, potential models and mechanisms. Brain, behavior, and immunity, 97, 275-285.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
APA Dictionary of Psychology https://dictionary.apa.org/posttraumatic-stress-disorder
Barer, Y., Chodick, G., Chodick, N. G., & Gurevich, T. (2022). Risk of Parkinson disease among adults with vs without posttraumatic stress disorder. JAMA Network Open, 5(8).
Bielas, H., Meister-Langraf, R. E., Schmid, J. P., Barth, J., Znoj, H., Schnyder, U., ... & Von Känel, R. (2018). C-reactive protein as a predictor of posttraumatic stress induced by acute myocardial infarction. General hospital psychiatry, 53, 125-130.
Boscarino, J. A., Forsberg, C. W., & Goldberg, J. (2010). A twin study of the association between PTSD symptoms and rheumatoid arthritis. Psychosomatic medicine, 72(5), 481-486.
Boscarino, J. A., Forsberg, C. W., & Goldberg, J. (2010). A twin study of the association between PTSD symptoms and rheumatoid arthritis. Psychosomatic medicine, 72(5), 481-486.
Buckley, T. C., & Kaloupek, D. G. (2001). A meta-analytic examination of basal cardiovascular activity in posttraumatic stress disorder. Psychosomatic medicine, 63(4), 585-594.
Chan, Y. L. E., Bai, Y. M., Hsu, J. W., Huang, K. L., Su, T. P., Li, C. T., ... & Chen, M. H. (2017). Post-traumatic stress disorder and risk of parkinson disease: a nationwide longitudinal study. The American Journal of Geriatric Psychiatry, 25(8), 917-923.
Dedert, E. A., Calhoun, P. S., Watkins, L. L., Sherwood, A., & Beckham, J. C. (2010). Posttraumatic stress disorder, cardiovascular, and metabolic disease: a review of the evidence. Annals of Behavioral Medicine, 39(1), 61-78.
Ebrahimi, R., Dennis, P. A., Alvarez, C. A., Shroyer, A. L., Beckham, J. C., & Sumner, J. A. (2024). Posttraumatic Stress Disorder Is Associated With Elevated Risk of Incident Stroke and Transient Ischemic Attack in Women Veterans. Journal of the American Heart Association, 13(5).
Edmondson, D., & von Känel, R. (2017). Post-traumatic stress disorder and cardiovascular disease. The Lancet Psychiatry, 4(4), 320-329.
Edmondson, D., & von Känel, R. (2017). Post-traumatic stress disorder and cardiovascular disease. The Lancet Psychiatry, 4(4), 320-329.
Gilsanz, P., Winning, A., Koenen, K. C., Roberts, A. L., Sumner, J. A., Chen, Q., ... & Kubzansky, L. D. (2017). Post-traumatic stress disorder symptom duration and remission in relation to cardiovascular disease risk among a large cohort of women. Psychological Medicine, 47(8), 1370-1378.
Goldstein, E., Chokshi, B., Melendez-Torres, G. J., Rios, A., Jelley, M., & Lewis-O’Connor, A. (2024). effectiveness of Trauma-Informed Care Implementation in health Care Settings: Systematic review of reviews and realist Synthesis. The Permanente Journal, 28(1), 135.
Gradus, J. L., Farkas, D. K., Svensson, E., Ehrenstein, V., Lash, T. L., Milstein, A., ... & Sørensen, H. T. (2015). Associations between stress disorders and cardiovascular disease events in the Danish population. BMJ open, 5(12), e009334.
Gradus, J. L., Farkas, D. K., Svensson, E., Ehrenstein, V., Lash, T. L., Milstein, A., ... & Sørensen, H. T. (2015). Posttraumatic stress disorder and cancer risk: a nationwide cohort study. European journal of epidemiology, 30, 563-568.
Greenland, P., Daviglus, M. L., Dyer, A. R., Liu, K., Huang, C. F., Goldberger, J. J., & Stamler, J. (1999). Resting heart rate is a risk factor for cardiovascular and noncardiovascular mortality: the Chicago Heart Association Detection Project in Industry. American journal of epidemiology, 149(9), 853-862.
Griffin, M. G. (2008). A prospective assessment of auditory startle alterations in rape and physical assault survivors. Journal of traumatic stress, 21(1), 91-99.
Harrison, D. G. (1994). Endothelial dysfunction in atherosclerosis. Arteriosclerosis: New Insights into Pathogenetic Mechanisms and Prevention, 87-102.
Hori, H., & Kim, Y. (2019). Inflammation and post‐traumatic stress disorder. Psychiatry and clinical neurosciences, 73(4), 143-153.
Hughes, J. W., Dennis, M. F., & Beckham, J. C. (2007). Baroreceptor sensitivity at rest and during stress in women with posttraumatic stress disorder or major depressive disorder. Journal of Traumatic Stress, 20(5), 667-676.
Hughes, J. W., Feldman, M. E., & Beckham, J. C. (2006). Posttraumatic stress disorder is associated with attenuated baroreceptor sensitivity among female, but not male, smokers. Biological Psychology, 71(3), 296-302.
Jakovljević, M., Babić, D., Crncević, Z., Martinac, M., Maslov, B., & Topić, R. (2008). Metabolic syndrome and depression in war veterans with post-traumatic stress disorder. Psychiatria Danubina, 20(3), 406-410.
Kellner, M., Yassouridis, A., Hübner, R., Baker, D. G., & Wiedemann, K. (2003). Endocrine and cardiovascular responses to corticotropin-releasing hormone in patients with posttraumatic stress disorder: a role for atrial natriuretic peptide?. Neuropsychobiology, 47(2), 102-108.
Kisely S, Crowe E, Lawrence D. Cancer-Related Mortality in People With Mental Illness. JAMA Psychiatry. 2013;70(2):209–217. doi:10.1001/jamapsychiatry.2013.278
Kubzansky LD, Bordelois P, Jun HJ, et al. The Weight of Traumatic Stress: A Prospective Study of Posttraumatic Stress Disorder Symptoms and Weight Status in Women. JAMA Psychiatry. 2014;71(1):44–51. doi:10.1001/jamapsychiatry.2013.2798
Lee, Y. C., Agnew‐Blais, J., Malspeis, S., Keyes, K., Costenbader, K., Kubzansky, L. D., ... & Karlson, E. W. (2016). Post‐traumatic stress disorder and risk for incident rheumatoid arthritis. Arthritis care & research, 68(3), 292-298.
Lima, B. B., Hammadah, M., Pearce, B. D., Shah, A., Moazzami, K., Kim, J. H., ... & Vaccarino, V. (2020). Association of posttraumatic stress disorder with mental stress–induced myocardial ischemia in adults after myocardial infarction. JAMA Network Open, 3(4), e202734-e202734.
Manoharan, M. P., Raja, R., Jamil, A., Csendes, D., Gutlapalli, S. D., Prakash, K., ... & Penumetcha, S. S. (2022). Obesity and coronary artery disease: an updated systematic review 2022. Cureus, 14(9).
Mason, S. M., Flint, A. J., Roberts, A. L., Agnew-Blais, J., Koenen, K. C., & Rich-Edwards, J. W. (2014). Posttraumatic stress disorder symptoms and food addiction in women by timing and type of trauma exposure. JAMA psychiatry, 71(11), 1271-1278.
Muniz Carvalho, C., Wendt, F. R., Maihofer, A. X., Stein, D. J., Stein, M. B., Sumner, J. A., ... & Polimanti, R. (2021). Dissecting the genetic association of C-reactive protein with PTSD, traumatic events, and social support. Neuropsychopharmacology, 46(6), 1071-1077.
O’Donovan, A., Cohen, B. E., Seal, K. H., Bertenthal, D., Margaretten, M., Nishimi, K., & Neylan, T. C. (2015). Elevated risk for autoimmune disorders in Iraq and Afghanistan veterans with posttraumatic stress disorder. Biological psychiatry, 77(4), 365-374.
Orr, S. P., Metzger, L. J., Lasko, N. B., Macklin, M. L., Hu, F. B., Shalev, A. Y., ... & Harvard/Veterans Affairs Post-traumatic Stress Disorder Twin Study Investigators. (2003). Physiologic responses to sudden, loud tones in monozygotic twins discordant for combat exposure: association with posttraumatic stress disorder. Archives of general psychiatry, 60(3), 283-288.
Passos, I. C., Vasconcelos-Moreno, M. P., Costa, L. G., Kunz, M., Brietzke, E., Quevedo, J., ... & Kauer-Sant'Anna, M. (2015). Inflammatory markers in post-traumatic stress disorder: a systematic review, meta-analysis, and meta-regression. The Lancet Psychiatry, 2(11), 1002-1012.
Perkins, J. D., Wilkins, S. S., Kamran, S., & Shuaib, A. (2021). Post-traumatic stress disorder and its association with stroke and stroke risk factors: A literature review. Neurobiology of Stress, 14, 100332.
Qassem, T., Aly-ElGabry, D., Alzarouni, A. et al. Psychiatric Co-Morbidities in Post-Traumatic Stress Disorder: Detailed Findings from the Adult Psychiatric Morbidity Survey in the English Population. Psychiatr Q 92, 321–330 (2021). https://doi.org/10.1007/s11126-020-09797-4
Rabe, S., Dörfel, D., Zöllner, T., Maercker, A., & Karl, A. (2006). Cardiovascular correlates of motor vehicle accident related posttraumatic stress disorder and its successful treatment. Applied psychophysiology and biofeedback, 31, 315-330.
Ryan, M. A., Smith, T. C., Smith, B., Amoroso, P., Boyko, E. J., Gray, G. C., ... & Hooper, T. I. (2007). Millennium Cohort: enrollment begins a 21-year contribution to understanding the impact of military service. Journal of clinical epidemiology, 60(2), 181-191.
Salamone, J. D., Correa, M., Farrar, A., & Mingote, S. M. (2007). Effort-related functions of nucleus accumbens dopamine and associated forebrain circuits. Psychopharmacology, 191, 461-482.
Scheeringa, M. S., Zeanah, C. H., Myers, L., & Putnam, F. (2004). Heart period and variability findings in preschool children with posttraumatic stress symptoms. Biological Psychiatry, 55(7), 685-691.
Scherrer, J. F., Salas, J., Lustman, P. J., Van Den Berk-Clark, C., Schnurr, P. P., Tuerk, P., ... & Chard, K. M. (2018). The role of obesity in the association between posttraumatic stress disorder and incident diabetes. JAMA psychiatry, 75(11), 1189-1198.
Schnurr, P. P., Spiro III, A., & Paris, A. H. (2000). Physician-diagnosed medical disorders in relation to PTSD symptoms in older male military veterans. Health Psychology, 19(1), 91.
Solter, V., Thaller, V., Karlović, D., & Crnković, D. (2002). Elevated serum lipids in veterans with combat-related chronic posttraumatic stress disorder. Croatian medical journal, 43(6), 685-689.
Song, H., Fang, F., Tomasson, G., Arnberg, F. K., Mataix-Cols, D., De La Cruz, L. F., ... & Valdimarsdóttir, U. A. (2018). Association of stress-related disorders with subsequent autoimmune disease. Jama, 319(23), 2388-2400.
Song, H., Fang, F., Tomasson, G., Arnberg, F. K., Mataix-Cols, D., De La Cruz, L. F., ... & Valdimarsdóttir, U. A. (2018). Association of stress-related disorders with subsequent autoimmune disease. Jama, 319(23), 2388-2400.
Sumner, J. A., Kubzansky, L. D., Elkind, M. S., Roberts, A. L., Agnew-Blais, J., Chen, Q., ... & Koenen, K. C. (2015). Trauma exposure and posttraumatic stress disorder symptoms predict onset of cardiovascular events in women. Circulation, 132(4), 251-259.
Sumner, J. A., Nishimi, K. M., Koenen, K. C., Roberts, A. L., & Kubzansky, L. D. (2020). Posttraumatic stress disorder and inflammation: untangling issues of bidirectionality. Biological psychiatry, 87(10), 885-897.
Thomsen, M., & Nordestgaard, B. G. (2014). Myocardial infarction and ischemic heart disease in overweight and obesity with and without metabolic syndrome. JAMA internal medicine, 174(1), 15-22.
Turner, J. H., Neylan, T. C., Schiller, N. B., Li, Y., & Cohen, B. E. (2013). Objective evidence of myocardial ischemia in patients with posttraumatic stress disorder. Biological Psychiatry, 74(11), 861-866.
Tursich, M., Neufeld, R. W. J., Frewen, P. A., Harricharan, S., Kibler, J. L., Rhind, S. G., & Lanius, R. A. (2014). Association of trauma exposure with proinflammatory activity: a transdiagnostic meta-analysis. Translational psychiatry, 4(7), e413-e413.
Van der Kolk, B. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma.
Vancampfort, D., Rosenbaum, S., Ward, P. B., Steel, Z., Lederman, O., Lamwaka, A. V., ... & Stubbs, B. (2016). Type 2 diabetes among people with posttraumatic stress disorder: systematic review and meta-analysis. Psychosomatic medicine, 78(4), 465-473.
Violanti JM, Andrew M, Burchfiel CM, Hartley TA, Charles LE, Miller DB. Post-traumatic stress symptoms and cortisol patterns among police officers. Policing: An International Journal of Police Strategies & Management. 2007; 30(2): 189–202.
Wathen, C. N., Schmitt, B., & MacGregor, J. C. (2023). Measuring trauma-(and violence-) informed care: A scoping review. Trauma, Violence, & Abuse, 24(1), 261-277.
Yashi, K., & Daley, S. F. (2023). Obesity and type 2 diabetes.
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Copyright (c) 2025 Jakub Moder, Aleksandra Sadowska , Aleksandra Welkier , Adam Sobiński, Joanna Miśkiewicz, Aleksandra Dudek, Patrycja Pietrusińska , Patrycja Śliwa-Tytko , Anna Dziewierz, Paula Kwaśniewska
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