Posttraumatic Stress Disorder and Gastrointestinal Disorders in the Danish Population.
Posttraumatic Stress Disorder and Gastrointestinal Disorders in the Danish Population.
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丹麦人口的创伤后应激障碍和胃肠道疾病。
DOI：
10.1097/ede.0000000000000622
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发表时间：
2017
期刊：
影响因子：
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通讯作者：
ToftSørensen,Henrik
中科院分区：
文献类型：
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作者：
Gradus,JaimieL;Farkas,DóraKörmendiné;Svensson,Elisabeth;Ehrenstein,Vera;Lash,TimothyL;ToftSørensen,Henrik
背景：创伤后应激障碍（PTSD）和胃肠道（GI）疾病之间关联的证据是混合的，部分原因是研究方法的差异。此外，将胃肠道疾病或症状作为一个整体类别进行检查的研究可能会模糊PTSD与个体胃肠道诊断之间的联系。方法：这项全国队列研究使用丹麦医疗登记数据，研究了1995年至2013年期间，有PTSD诊断的患者（n= 4076）所有主要非恶性胃肠道疾病的发病率，并与普通人群发病率进行了比较。我们检查了性别、年龄、婚姻状况、精神和躯体共病以及随访时间的差异。计算风险、标准化发病率（SIRs）和置信区间（95% ci）。结果：PTSD患者发生任何胃肠道疾病的风险为25%(95% CI: 21%, 29%)；任何胃肠道疾病的SIR均为1.8 （95% CI: 1.7, 2.0）。风险和SIRs因疾病而异（例如，与肠憩室无关联[SIR: 1.1, 95% CI: 0.83, 1.5]；与消化性溃疡有更强的关联，部位未明确[SIR: 3.3, 95% CI: 1.8, 5.5]）。分层分析显示，PTSD诊断时年龄在16-39岁或未婚者、合并精神疾病诊断者和PTSD诊断后一年的相关程度更强。结论：本研究在未选择的长期随访的全国队列中记录了临床诊断的创伤后应激障碍与所有主要非恶性胃肠道疾病之间的关联。不同胃肠道疾病和重要调节剂之间的关联差异可能解释了之前相互矛盾的研究结果。
Background:Evidence for the association between posttraumatic stress disorder (PTSD) and gastrointestinal (GI) disorders is mixed, owing in part to methodologic differences across studies. Furthermore, studies which have combined GI disorders or symptoms for examination as one overall category may potentially obscure associations between PTSD and individual GI diagnoses.Methods:This nationwide cohort study examined the incidence of all major nonmalignant GI disorders in patients with a prior PTSD diagnosis (n= 4,076), compared with the general population incidence from 1995 to 2013, using Danish medical registry data. We examined differences by sex, age, marital status, psychiatric and somatic comorbidity, and follow-up time. Risks, standardized incidence rates (SIRs), and confidence intervals (95% CIs) were calculated.Results:Risk of any GI disorder among PTSD patients was 25%(95% CI: 21%, 29%); the SIR for any GI disorder was 1.8 (95% CI: 1.7, 2.0). Risk and SIRs varied by disorder (eg, no association with diverticula of the intestines [SIR: 1.1, 95% CI: 0.83, 1.5]; stronger association with peptic ulcer, site unspecified [SIR: 3.3, 95% CI: 1.8, 5.5]). Stratified analyses revealed that some associations were stronger for persons ages 16–39 or unmarried at PTSD diagnosis, persons with comorbid psychiatric diagnoses, and in the year following PTSD diagnosis.Conclusions:This study documents associations between clinician-diagnosed PTSD and all major nonmalignant GI disorders in an unselected nationwide cohort with long follow-up. Differences in associations across GI disorders and important modifiers may account for previous conflicting research findings.