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PTSD SUFFERERS AT GREATER RISK OF HEART ATTACK
AND
HAVE REDUCED PAIN SENSITIVITY -- Two landmark
studies shed new light on health problems
for those with stress disorder.
We have two stories.
The first is about PTSD and risk of heart
attacks...the second is about PTSD and reduced pain sensitivity.
First story here...
http://www.washingtonpost.com/wp-dyn/
content/article/2007/01/01/AR2007010100456.html
Story below:
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`Study: War Trauma May Raise Heart Risks
By CARLA K. JOHNSON
The Associated Press
CHICAGO -- A groundbreaking study of 1,946 male veterans of World War II
and Korea suggests that vets with symptoms of post-traumatic stress
disorder are at greater risk of heart attacks as they age.
The new study is the first to document a link between PTSD symptoms and
future heart disease, and joins existing evidence that vets with PTSD
also have more autoimmune diseases such as arthritis and psoriasis.
A second study, funded by the Army, found that soldiers returning from
combat in Iraq with post-traumatic stress disorder reported worse
physical health, more doctor visits and more missed workdays. The Army
study is based on a survey of 2,863 soldiers one year after combat.
"The burden of war may be even greater than people think," said the
first study's lead author, Laura Kubzansky of the Harvard School of
Public Health, who studies anxiety, depression and anger as risk factors
for heart disease. Her work, with colleagues from Harvard and Boston
University, appears in Monday's Archives of General Psychiatry.
Their study was funded by the National Institutes of Health and the
Department of Veterans Affairs. The Army study appears in Monday's
American Journal of Psychiatry.
The possible link with heart disease didn't surprise one Iraq veteran
diagnosed with PTSD.
"It didn't take a rocket scientist to figure out," said John Oliveira of
New Bedford, Mass., a former Navy public affairs officer and veteran of
Iraq and Afghanistan. "It should also be a wake-up call that the cost to
treat those of us suffering from PTSD could dramatically increase as we
age."
Medical authorities first accepted post-traumatic stress disorder as a
psychiatric condition in 1980 at the urging of Vietnam veterans.
In PTSD, the body's normal hormonal response to stress becomes
trigger-happy, scientists believe. Long after traumatic events, people
remain edgy, fearful and prone to nightmares and flashbacks. The
continual release of adrenaline prompted by these symptoms may wear down
the cardiovascular system, Kubzansky said.
"It's not enough to simply welcome them home and do some immediate
evaluation or help with reintegration," she said. "They need to be
tracked and watched carefully."
The Harvard and Boston University researchers analyzed data from the
Veterans Administration Normative Aging Study, a long-term research
project tracking Boston-area vets.
They looked at health records of men who completed either a 46-item
questionnaire measuring PTSD symptoms in 1986, or a different 35-item
PTSD assessment in 1990. Both questionnaires are recognized tools for
diagnosing PTSD and ask about symptoms such as sleep problems,
nightmares, numbness, a heightened sense of being on guard and intrusive
memories of traumatic events.
Over the 10 to 15 years after completing the questionnaires, the vets
with more PTSD symptoms were more likely to have heart attacks. For each
level increase in symptoms on the 1990 assessment, the risk of heart
attack or chest pain rose 18 percent _ even after the researchers took
into account known heart disease risk factors such as smoking, alcohol
use and high blood pressure.
Although the men had different levels of PTSD symptoms, very few had
enough symptoms for a true diagnosis, Kubzansky said. The study needs to
be repeated to see if the findings hold true for PTSD-diagnosed
veterans, and for women, she said.
The data also didn't track how frequently the men exercised, so
researchers couldn't tell if the men with PTSD symptoms were getting
more or less exercise than other veterans.
Dr. Gary J. Kennedy, director of geriatric psychiatry at Montefiore
Medical Center, called the study "impressive." He said one symptom of
PTSD is avoiding activity, which could account for some of the effect on
the heart.
Kennedy, who was not involved in the study, said treatment options for
PTSD include drugs, talk therapy and behavioral changes such as getting
more exercise and taking action to solve small problems in life rather
than shutting down emotionally.
"We've got a whole generation of veterans coming back (from Iraq and
Afghanistan) and their health needs are just going to be tremendous,"
Kennedy said.
___
On the Net:
Archives of General Psychiatry:
http://archpsyc.ama-assn.org/
---------------
Second story here...
http://psychcentral.com/
news/2007/01/02/ptsd-alters-pain-response/
Story below:
---------------
PTSD Alters Pain Response
By: Psych Central News Editor
Reviewed by: John M. Grohol, Psy.D.
Scientists discover patients with posttraumatic stress disorder (PTSD)
are less sensitive to pain, a finding that may be related to altered
pain processing in the brain. Dutch researchers used functional brain
imaging along with psychophysical assessment as individuals rated the
pain they experienced from variable and fixed temperatures applied to
their hands.
The research is reported in the January issue of the Archives of General
Psychiatry, one of the JAMA/Archives journals.
Posttraumatic stress disorder (PTSD) is an anxiety disorder that may
occur in individuals exposed to a traumatic event. It is characterized
by chronic arousal, re-experience of the event, and avoidance of stimuli
related to the event, according to background information in the
article. To the authors’ knowledge, no functional imaging study has
explored whether patients with PTSD experience and process pain in a
different way than control subjects.
Elbert Geuze, Ph.D., of Central Military Hospital and the Rudolph Magnus
Institute of Neuroscience, Utrecht, the Netherlands, and colleagues
conducted a study to examine neural correlates of pain processing in
patients with PTSD. Twelve male Dutch veterans with PTSD and 12 male
veterans without PTSD were recruited and matched for age, region of
deployment and year of deployment.
The experimental procedure consisted of psychophysical assessment and
neuroimaging with functional magnetic resonance imaging (fMRI)–the use
of magnetic resonance imaging to learn which regions of the brain are
active in a specific function. During fMRI, the patients rated the pain
they experienced from fixed and variable temperatures applied to their
hands.
“Patients with PTSD rated temperatures in the fixed-temperature
assessment as less painful compared with controls,” the authors report.
“Before fMRI, patients with PTSD already showed a significant reduction
in pain sensitivity,” the authors write. “During imaging, patients with
PTSD rated a fixed temperature as significantly less painful than
control veterans.” Patients with PTSD showed altered pain processing in
brain areas associated with mood and cognitive pain processing.
“These data provide evidence for reduced pain sensitivity in PTSD. The
witnessed neural activation pattern is proposed to be related to altered
pain processing in patients with PTSD,” the authors conclude.
Source:
http://archpsyc.ama-assn.org/
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Larry Scott
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