Is the association between posttraumatic stress disorder symptoms and poor health due to a common familial or genetic factor?

Roy-Byrne, Peter P.; Noonan, Carolyn; Afari, Niloofar; Buchwald, Dedra; Goldberg, Jack

doi:10.1016/j.genhosppsych.2006.05.007

« Previous Next »General Hospital Psychiatry
Volume 28, Issue 5 , Pages 408-413, September 2006

Is the association between posttraumatic stress disorder symptoms and poor health due to a common familial or genetic factor?

Peter P. Roy-Byrne, M.D.
- Department of Psychiatry and Behavioral Sciences, University of Washington at Harborview Medical Center, Seattle, WA 98104, USA
- Corresponding author. Tel.: +1 206 341 4201; fax: +1 206 731 3236.
Carolyn Noonan, M.S.
- Department of Medicine, University of Washington, Seattle, WA 98195, USA
Niloofar Afari, Ph.D.
- Department of Psychiatry and Behavioral Sciences, University of Washington at Harborview Medical Center, Seattle, WA 98104, USA
Dedra Buchwald, M.D.
- Department of Medicine, University of Washington, Seattle, WA 98195, USA
Jack Goldberg, Ph.D.
- Department of Epidemiology, University of Washington, Seattle, WA 98195, USA
- Vietnam Era Twin Registry, VA Puget Sound Health Care System, Seattle, WA 98112, USA

Received 17 January 2006; accepted 18 May 2006.

Abstract

Objective

The objective of this study was to identify genetic, familial and environmental contributions to the association between posttraumatic stress disorder (PTSD) symptoms and poor health.

Methods

A community sample of 1852 twin pairs was assessed for symptoms of PTSD [with the Impact of Events Scale (IES)] and self-reported global health status using a single five-level question. An ordinal logistic regression model estimated odds ratio/s (OR) for the association between PTSD and health status. Within-pair analysis assessed confounding by familial and genetic factors and adjusted for the possible confounding influence of age, sex, race, education and self-reported physician diagnosis of depression.

Results

The IES was strongly and significantly associated with self-reported health [OR=1.8; 95% confidence interval (95% CI)=1.5–2.2; highest quartile vs. lowest quartile]. This association remained significant in within-pair analysis (OR=1.3; 95% CI=1.0–1.7), but after further adjustment for sociodemographics and depression, it was no longer significant (P_trend=.17). Separate analysis by zygosity did not show differential effect in monozygotic or dizygotic pairs.

Conclusion

These findings suggest that the association between PTSD symptoms and poor health is, in part, due to familial confounding and sociodemographic factors. Little evidence of confounding by genetic factors was found. These findings suggest that early prevention efforts would have the greatest potential for improving poor health in PTSD-prone patients, whereas later intervention efforts directed at treating PTSD may have a more limited impact on improving poor health.

Keywords: Posttraumatic stress disorder, Poor health, Familial, Genetic, Twin