The Link Between Post-traumatic Stress Disorder and Physical Comorbidities: A Systematic Review

Context 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. Data Sources 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. Study Selection 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. Data Extraction 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.