Comorbidity Profiles of Posttraumatic Stress Disorder Across the Medical Phenome
Year: 2024
Type: article
Study design: Observational Study
Abstract: Background Prior epidemiological research has linked PTSD with specific physical health problems, but the comprehensive landscape of medical conditions associated with PTSD remains uncharacterized. Electronic health records (EHR) provide an opportunity to overcome prior clinical knowledge gaps and uncover associations with biological relevance that potentially vary by sex. Methods PTSD was defined among biobank participants (total N=123,365) in a major healthcare system using two ICD code-based definitions: broad (1+ PTSD or acute stress codes versus 0; N Case =14,899) and narrow (2+ PTSD codes versus 0; N Case =3,026). Using a phenome-wide association (PheWAS) design, we tested associations between each PTSD definition and all prevalent disease umbrella categories, i.e., phecodes. We also conducted sex-stratified PheWAS analyses including a sex-by-diagnosis interaction term in each logistic regression. Results A substantial number of phecodes were significantly associated with PTSD Narrow (61%) and PTSD Broad (83%). While top associations were shared between the two definitions, PTSD Broad captured 334 additional phecodes not significantly associated with PTSD Narrow and exhibited a wider range of significantly associated phecodes across various categories, including respiratory, genitourinary, and circulatory conditions. Sex differences were observed, in that PTSD Broad was more strongly associated with osteoporosis, respiratory failure, hemorrhage, and pulmonary heart disease among male patients, and with urinary tract infection, acute pharyngitis, respiratory infections, and overweight among female patients. Conclusions This study provides valuable insights into a diverse range of comorbidities associated with PTSD, including both known and novel associations, while highlighting the influence of sex differences and the impact of defining PTSD using EHR.
Institutions: Icahn School of Medicine at Mount Sinai, Vanderbilt University Medical Center, Massachusetts General Hospital, Yale University, Broad Institute, Stanley Center for Psychiatric Research, University of California San Diego, VA San Diego Healthcare System, Center of Excellence for Stress and Mental Health, Harvard University
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $3,500
Funders: U.S. Department of Justice, Biogen, Vanderbilt University, Icahn School of Medicine at Mount Sinai, National Alliance for Research on Schizophrenia and Depression, Vanderbilt University Medical Center, Georgia Clinical and Translational Science Alliance, University of Oxford, National Institutes of Health, National Heart, Lung, and Blood Institute, National Institute of Mental Health, National Human Genome Research Institute, NIH Office of the Director, National Institute of General Medical Sciences, National Institute of Neurological Disorders and Stroke, National Institute of Environmental Health Sciences, National Center for Research Resources, Office of Research on Women's Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Awards: Pharmacogenomics of Arrhythmia Therapy, G1531600799, G1696708022, G1766209448, G2103760183, Understanding the genetic risk underlying racial disparities in uterine fibroids, G2368233345, G2615776415, G2683268942, Transforming Genomics with 5 PB Big Omics Data Engine Cray CS300-AC Supercomputer, Improving Prediction of Drug Action, G3395468139, G3619590958, G364208108, G3791753988, G3938985443, G4049315607, Automated Storage and Retrieval of Biological Systems, G4395870004, G4410787187, Overall: Eunice Kennedy Shriver Intellectual and Developmental Disabilities Research Center at Vanderbilt, G5366963641, G560889077, G5679716143, G5689014751, G5717004637, Genetic Epidemiology of Multiple Sclerosis, Elucidating the phenome-wide impact of sex and gender on disease, G6589054092, The Vanderbilt Institute for Clinical and Translational Research (VICTR) UL1, VESPA: Vanderbilt Electronic Systems for Pharmacogenomic Assessment, G7163342664, The Vanderbilt Institute for Clinical and Translational Research (VICTR), Vanderbilt Genome Electronic Records Project, PsycheMERGE: Leveraging electronic health records and genomics for mental health research, Predicting the multi-omic impact of psychiatric GWAS associations, G8098630230, Epidemiologic Architecture for Genes Linked to Environment (EAGLE), G8332127685, Genetic Privacy and Identity in Community Settings - GetPreCiSe, G861748693, Modeling the interaction of physiological and environmental stressors on common variants to psychiatric traits, 3/7 Psychiatric Genomics Consortium: Advancing Discovery and Impact, Vanderbilt Institute for Clinical and Translational Research (VICTR), Psychiatric Genomics Consortium for PTSD, Integrating Health Records, Genomic, and Social Data to Stratify Adolescent Depression Risk
OpenAlex ID: W4399142991