Can PTSD treatment reduce risk for chronic health conditions?

  • Scherrer JF & al.
  • JAMA Psychiatry
  • 21 Aug 2019

  • International Clinical Digest
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Takeaway

  • Clinically meaningful reductions in symptoms of posttraumatic stress disorder (PTSD) are associated with lower risk of type 2 diabetes (T2D).
  • A decrease in PTSD Checklist (PCL) score, via treatment or spontaneous improvement, may help mitigate the T2D risk in patients with PTSD.

Why this matters

  • PTSD is associated with increased T2D risk.

Study design

  • Retrospective analysis of Veterans Health Affairs medical records for 1598 patients (84.3% male) who received PTSD specialty care during 2008-2012, followed for 2-6 years.
  • All had baseline PCL scores ≥50.
  • Clinically meaningful improvement defined as ≥20-point PCL score decrease vs less/no improvement (
  • Funding: NIH.

Key results

  • Clinically meaningful PCL decreases occurred in 339 (21.2%) participants and less-than-clinically-meaningful change occurred in 1259 (78.8%).
  • Age-adjusted T2D incidence was significantly lower in the group with vs without clinically meaningful PCL score decreases (7.3 vs 16.0 per 1000 person-years; P=.005).
  • HR for T2D with meaningful vs nonmeaningful PCL score decrease was 0.50 (P=.02), remaining significant after adjustment for age (0.45; P=.01) and for multiple additional covariates (0.51; P=.04).  

Limitations

  • Possible unmeasured confounding.
  • Insufficient follow-up time.
  • Types of trauma not analyzed.
  • Results may not be generalizable to nonveteran populations.