BACKGROUND Increasing evidence suggests a link between posttraumatic stress disorder (PTSD) and physical health. Stress disorders may lead to impairment of the immune system and subsequent autoimmune disease. This study investigated the association between PTSD and risk of selected autoimmune diseases (i.e. rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel diseases, and multiple sclerosis) among US active duty service members. METHODS Using data from the Millennium Cohort Study, incident autoimmune cases between study initiation and September 2015 were identified from medical encounter records in the Military Health System Data Repository (MDR). Participants were classified as having a history of PTSD if they self-reported receiving a health care provider's diagnosis of PTSD or if they screened positive using the PTSD Checklist-Civilian Version. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox regression models adjusted for demographics and history of another mental health condition. RESULTS Among 120,572 participants followed for a mean of 5.2 years, risk of any of the selected autoimmune diseases was 58% higher for those with a history of PTSD (HR = 1.58, 95% CI: 1.25, 2.01) compared with no history of PTSD. Further adjustment for BMI, smoking status, and alcohol use had little impact on the effect estimates, and results were not appreciably different according to combat experience and history of physical or sexual trauma. CONCLUSIONS Active duty military personnel with PTSD may have an elevated risk of a range of autoimmune diseases, regardless of combat experience or prior trauma. Future research is needed to understand potential mechanisms which may inform future mitigative strategies in reducing extra-neuropsychiatric health problems among those with PTSD.

中文翻译：

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创伤后应激障碍和美国军事人员中某些自身免疫性疾病的风险。

背景技术越来越多的证据表明创伤后应激障碍（PTSD）与身体健康之间存在联系。压力障碍可能导致免疫系统受损和随后的自身免疫性疾病。这项研究调查了美国现役军人中PTSD与某些自身免疫性疾病（即类风湿性关节炎，系统性红斑狼疮，炎性肠病和多发性硬化症）风险之间的关联。方法利用千年队列研究的数据，从军事卫生系统数据存储库（MDR）的医疗遭遇记录中识别出研究开始至2015年9月之间的自身免疫事件。如果参与者自我报告接受了卫生保健提供者的调查，则被归类为有PTSD病史 对PTSD的诊断，或者使用PTSD检查表民用版进行筛查是否为阳性。使用多变量Cox回归模型对危险比（HRs）和95％置信区间（CIs）进行了估算，该模型针对人口统计学和另一种精神疾病的病史进行了调整。结果在120​​,572名平均随访5.2年的参与者中，有PTSD病史的患者（HR = 1.58，95％CI：1.25，2.01）与没有PTSD病史的患者相比，选择任何自身免疫性疾病的风险高58％ 。进一步调整BMI，吸烟状况和饮酒对效果的估计影响不大，根据战斗经验和身体或性创伤的历史，结果没有明显差异。结论患有PTSD的现役军人可能患有多种自身免疫性疾病，无论战斗经验或先前的创伤如何。需要进行进一步的研究以了解可能的机制，这些机制可能有助于减少PTSD患者中减少神经外精神卫生问题的未来缓解策略。