학술논문

Is Post-Traumatic Stress Disorder Associated with Premature Senescence? A Review of the Literature
Document Type
article
Source
American Journal of Geriatric Psychiatry. 23(7)
Subject
Biomedical and Clinical Sciences
Clinical Sciences
Aging
Clinical Research
Mental Health
Post-Traumatic Stress Disorder (PTSD)
Brain Disorders
Good Health and Well Being
Aging
Premature
Biomarkers
Comorbidity
Humans
Mortality
Premature
Quality of Life
Risk Factors
Stress Disorders
Post-Traumatic
PTSD
aging
mortality
telomere
dementia
Public Health and Health Services
Cognitive Sciences
Geriatrics
Clinical sciences
Health services and systems
Clinical and health psychology
Language
Abstract
ObjectivePost-traumatic stress disorder (PTSD) has major public health significance. Evidence that PTSD may be associated with premature senescence (early or accelerated aging) would have major implications for quality of life and healthcare policy. We conducted a comprehensive review of published empirical studies relevant to early aging in PTSD.MethodOur search included the PubMed, PsycINFO, and PILOTS databases for empirical reports published since the year 2000 relevant to early senescence and PTSD, including: 1) biomarkers of senescence (leukocyte telomere length [LTL] and pro-inflammatory markers), 2) prevalence of senescence-associated medical conditions, and 3) mortality rates.ResultsAll six studies examining LTL indicated reduced LTL in PTSD (pooled Cohen's d = 0.76). We also found consistent evidence of increased pro-inflammatory markers in PTSD (mean Cohen's ds), including C-reactive protein = 0.18, Interleukin-1 beta = 0.44, Interleukin-6 = 0.78, and tumor necrosis factor alpha = 0.81. The majority of reviewed studies also indicated increased medical comorbidity among several targeted conditions known to be associated with normal aging, including cardiovascular disease, type 2 diabetes mellitus, gastrointestinal ulcer disease, and dementia. We also found seven of 10 studies indicated PTSD to be associated with earlier mortality (average hazard ratio: 1.29).ConclusionIn short, evidence from multiple lines of investigation suggests that PTSD may be associated with a phenotype of accelerated senescence. Further research is critical to understand the nature of this association. There may be a need to re-conceptualize PTSD beyond the boundaries of mental illness, and instead as a full systemic disorder.