Asthma Risk Significantly Increases With Posttraumatic Stress Disorder

A significant link between posttraumatic stress disorder (PTSD) and asthma, particularly in patients younger than 20 years, indicates a need for physicians and public health officials to perform surveillance and interventions in patients with PTSD, according to a study published in Psychiatry Research.

Evidence suggests that PTSD interferes with the immune system and is correlated with respiratory disease, cardiovascular disease, and chronic pain.

This longitudinal study was designed to assess the association between PTSD and asthma. Researchers used a national Taiwanese database to identify participants with PTSD (N=5518) and age- and sex-matched healthy individuals (N=22,072) and enroll them from 2001 to 2009 with follow-up through the end of 2011. Individuals who developed asthma during follow-up were identified. Hazard ratios (HRs) with 95% CIs for asthma risk after adjusting for demographics and comorbidities were investigated using the Cox proportional hazard regression model, and findings were validated using sensitivity tests after excluding observations of the first year or allergic comorbidities.

During the follow-up period, 146 participants with PTSD were diagnosed with asthma compared with 199 control participants, with an incidence rate of 4.74 and 1.59 (1000 person-years), respectively. Patients with PTSD were shown to have an increased risk for asthma (HR, 2.27), particularly in patients younger than 20 (HR, 4.01). The risk of participants with PTSD developing asthma was significantly higher compared with the controls. In addition, the main findings of elevated asthma risk were still consistent after excluding the first year of surveillance or other allergic disorders (HR, 1.62 and 2.21, respectively), indicating that PTSD may be an independent risk factor.

Investigators concluded, “[T]he present study showed a significant link between PTSD and asthma after adjusting for demographic data and related comorbidities. Public health officials and physicians should focus on performing surveillance and interventions in patients with PTSD, particularly children and adolescents.” They also pointed out that additional studies are needed to clarify mechanisms underlying the association between PTSD and asthma.

Reference

Hung Y-H, Cheng C-M, Lin W-C, et al. Post-traumatic stress disorder and asthma risk: a nationwide longitudinal study. Psychiatry Res. 2019;276:25-30. doi:10.1016/j.psychres.2019.04.014