Trauma exposure, PTSD in women may lead to autoimmune disease
Women with trauma exposure or post-traumatic stress disorder (PTSD) have a more than twofold risk of developing systemic lupus erythematosus (SLE), a study suggests.
The longitudinal study included 54,763 women who completed the Short Screening Scale for DSM-IV PTSD and the Brief Trauma Questionnaire. These women were categorized as follows: no trauma, trauma and no PTSD symptoms, subclinical PTSD (one to three symptoms), or probable PTSD (four to seven symptoms).
Incident SLE with ≥4 American College of Rheumatology criteria was self-reported, with subsequent confirmation by medical record review. Longitudinally assessed health risk factors (eg, smoking, body mass index [BMI], oral contraceptive use) were also examined whether they accounted for increased SLE risk among women with vs without trauma exposure and PTSD.
During 24 years of follow-up, 73 women developed SLE. Compared with no trauma, probable PTSD increased SLE risk by nearly threefold (hazard ratio [HR], 2.94; 95 percent CI, 1.19 to 7.26; p<0.05). Subclinical PTSD also increased SLE risk, although this association was not statistically significant (HR, 1.83; 0.74 to 4.56; p=0.19).
Smoking, BMI and oral contraceptive use slightly attenuated the observed associations (eg, probable PTSD: adjusted HR, 2.62; 1.09 to 6.48; p<0.05).
Regardless of PTSD symptoms, trauma exposure showed a strong association with incident SLE (HR, 2.87; 1.31 to 6.28; p<0.01).
The present data add to growing evidence that psychosocial trauma and associated stress responses lead to autoimmune disease, researchers said.
“Identification of the biological pathways by which psychosocial trauma may increase risk for autoimmune disease is crucial and may provide greater insight into disease aetiology, as well as strategies for prevention. In addition, identification of mechanisms by which trauma and PTSD are associated with increased risk of SLE may indicate mechanisms for the association of PTSD and trauma exposure with other chronic diseases,” they added.