Chronic Somatic Diseases associated with higher incidence of post-traumatic stress disorder

Germany: A new study found that there is a high prevalence of post-traumatic stress disorder (PTSD) and symptoms (PTSS) in chronic somatic diseases (CD) patients. The study results were published in the journal Frontiers in Psychiatry. 

The chronic somatic disease is affecting the majority of adults globally and affects their quality of life. It is associated with a multitude of challenges due to complex treatment plans and also stress, anxiety and depression. As there is limited research on the prevalence and incidence of post-traumatic stress disorder (PTSD) and symptoms (PTSS) in people with chronic somatic diseases (CD), Frederike Lunkenheimer et al from the University of Ulm, Germany conducted a systematic review and meta-analysis to examine prevalence and incidence of PTSD and PTSS in people with CD compared with people without CD. 

Databases like MEDLINE, Embase, and PsycINFO were searched from inception (1946) to June 2020. As per the PRISMA guidelines, studies reporting point, 12-month, lifetime prevalence, or 12-month incidence of PTSD and PTSS in people with CD were selected and reviewed by two independent reviewers. A combination of the Newcastle-Ottawa Scale and recommendations of the Cochrane Collaboration for non-comparative studies were used to assess the risk of bias. Random effects meta-analyses were used to calculate the Pooled estimates. The I2 statistic was used to assess the between-study heterogeneity. 

Key findings: 

• Studies that reported on point prevalence (k=60; n=21,213), 12-month prevalence (k=3; n=913), and lifetime prevalence (k=6; n=826) were only included and data was extracted.
• There were data available on the 12-month incidence estimates. 
• The pooled estimate for the point prevalence of PTSD (k=41) across CD was 12.7% and 19.6% regarding PTSS (k=24).
• The highest pooled point prevalence for PTSD was shown by individuals with the cerebrovascular disorder (k=4, 23.6%), while those with cardiovascular diseases showed the lowest (6.6%, k=5).
• The pooled 12-month prevalence of PTSD (k=3) was 8.8% and the lifetime prevalence (k=6) was 12.1%.
• The PTSD prevalence in people with compared to those without CD showed an odds ratio of 9.96 using pooled estimates. 

Thus, the prevalence of PTSD and PTSS is higher in patients with CD compared to those without. Hence, early identification and management might improve mental and physical health, further reducing morbidity and mortality. 

Further reading: Prevalence and incidence of post-traumatic stress disorder and symptoms in people with chronic somatic diseases: A systematic review and meta-analysis. Frontiers in Psychiatry. Doi:  10.3389/fpsyt.2023.1107144