This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (39)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Psychiatry  • Depression  • Women's Health  • Women's Health, Other  • Alert me on articles by topic  Social Bookmarking   What's this?

Susan M. Frayne, MD, MPH; Margaret R. Seaver, MD, MPH; Susan Loveland, MAT; Cindy L. Christiansen, PhD; Avron Spiro III, PhD; Victoria A. Parker, DBA; Katherine M. Skinner, PhD

Arch Intern Med. 2004;164:1306-1312.

Background  Depression and posttraumatic stress disorder (PTSD) are important women's health issues. Depression is known to be associated with poor physical health; however, associations between physical health and PTSD, a common comorbidity of depression, have received less attention.

Objectives  To examine number of medical symptoms and physical health status in women with PTSD across age strata and benchmark them against those of women with depression alone or with neither depression nor PTSD.

Methods  A random sample of Veterans Health Administration enrollees received a mailed survey in 1999-2000 (response rate, 63%). The 30 865 women respondents were categorized according to whether a health care provider had ever told them that they had PTSD, depression (without PTSD), or neither. Outcomes were self-reported medical conditions and physical health status measured with the Veterans SF-36 instrument, a version of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) modified for use in veteran populations.

Results  Across age strata, women with PTSD (n = 4348) had more medical conditions and worse physical health status (physical functioning, role limitations due to physical problems, bodily pain, and energy/vitality scales from the Veterans SF-36) than women with depression alone (n = 7580) or neither (n = 18 937). In age-adjusted analyses, the Physical Component Summary score was on average 3.4 points lower in women with depression alone and 6.3 points lower in women with PTSD than in women with neither (P<.001).

Conclusions  Posttraumatic stress disorder is associated with a greater burden of medical illness than is seen with depression alone. The presence of PTSD may account for an important component of the excess medical morbidity and functional status limitations seen in women with depression.

From Center for Health Care Evaluation, Veterans Affairs Palo Alto Health Care System, Menlo Park, Calif (Dr Frayne); Department of Medicine, Boston University School of Medicine (Drs Frayne and Seaver), Boston University School of Public Health (Drs Frayne, Christiansen, Spiro, Parker, and Skinner and Ms Loveland), Veterans Affairs Boston Healthcare System (Dr Seaver), and Massachusetts Veterans Epidemiology Research & Information Center (Dr Spiro), Boston, Mass; and Center for Health Quality, Outcomes and Economic Research, Veterans Affairs Medical Center, Bedford Mass (Drs Christiansen, Spiro, Parker, and Skinner and Ms Loveland). The authors have no relevant financial interest in this article.
Dr Skinner is deceased.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Suicide Mortality Among Patients Receiving Care in the Veterans Health Administration Health System
McCarthy et al.
Am J Epidemiol 2009;169:1033-1038.
ABSTRACT | FULL TEXT  

Serum phospholipid n 3 long-chain polyunsaturated fatty acids and physical and mental health in a population-based survey of New Zealand adolescents and adults
Crowe et al.
Am. J. Clin. Nutr. 2007;86:1278-1285.
ABSTRACT | FULL TEXT  

Physical and Mental Comorbidity, Disability, and Suicidal Behavior Associated With Posttraumatic Stress Disorder in a Large Community Sample
Sareen et al.
Psychosom. Med. 2007;69:242-248.
ABSTRACT | FULL TEXT  

Association of Posttraumatic Stress Disorder With Somatic Symptoms, Health Care Visits, and Absenteeism Among Iraq War Veterans
Hoge et al.
Am. J. Psychiatry 2007;164:150-153.
ABSTRACT | FULL TEXT  

Disparities in Diabetes Care: Impact of Mental Illness
Frayne et al.
Arch Intern Med 2005;165:2631-2638.
ABSTRACT | FULL TEXT  

Biological Underpinnings of Health Alterations in Women With PTSD: A Sex Disparity
Gill et al.
Biol Res Nurs 2005;7:44-54.
ABSTRACT  

How Trauma, Recent Stressful Events, and PTSD Affect Functional Health Status and Health Utilization in HIV-Infected Patients in the South
Leserman et al.
Psychosom. Med. 2005;67:500-507.
ABSTRACT | FULL TEXT