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 Researchers examined data on 144,919 people diagnosed with
post-traumatic stress disorder (PTSD), adjustment disorders common
after a major life change like a death or move, and other
stress-related conditions. They also looked at data for 184,612
siblings of these subjects who didn't have a stress disorder, along
with more than 1.4 million unrelated individuals without these
disorders.
After an average follow-up of eight years, the annual incidence of
life-threatening infections – including infections of the nervous
system or heart - was 2.9 in every 1,000 people with stress
disorders, compared with 1.7 in every 1,000 siblings and 1.3 in
every 1,000 unrelated individuals.
"Severe or prolonged emotional stress causes alterations in multiple
bodily functions through dysregulation in the release of stress
hormones," said Dr. Huan Song, lead author of the study and a
researcher at the Karolinska Institute in Stockholm.
"The hypothesis behind our research is that a severe reaction to
trauma or other life stressors, through these pathways, leads to
impaired immune function and thereby susceptibility to infection,"
Song said by email.
Previous research has linked stress to an increased risk of acute
and respiratory infections, the study authors note in The BMJ. The
current analysis, however, focused only on life-threatening
infections, including endocarditis caused by infections of the
lining of the heart chambers and heart valves, meningitis and other
nervous system infections, and infections that lead to sepsis.
During the study, a total of 2,197 people with a history of stress
disorders developed life-threatening infections, as did 2,646 of
their siblings.
People with stress disorders were 47% more likely to develop
infections than those without any history of stress-disorders.
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When people with stress disorders took certain antidepressant
medications over the first year after their diagnosis, they were 19%
less likely to develop life-threatening infections later on, the
study also found.
The study wasn't a controlled experiment designed to prove whether
or how stress disorders might increase risk of infections, or to
what extent any treatment for stress might alter the infection risk.
One limitation of the analysis is that it relied on outpatient
clinic records to identify people with stress disorders, and it's
possible this might have omitted patients with milder cases, the
study authors note.
Researchers also lacked data on certain lifestyle habits that can
also impact infection risk, like smoking, drinking and illegal drug
use.
Even so, the findings add to a large body of evidence linking PTSD
and other stress-related mental health problems to an increased risk
of poor physical health, Jonathan Bisson of Cardiff University
School of Medicine in the UK writes in an editorial accompanying the
study.
"The main message to patients suffering from severe emotional
reactions after trauma or other life stressors is it is important to
seek treatment or timely medical care," Song said.
SOURCE: https://bit.ly/2C10Yp6 and https://bit.ly/2WAQUwz The BMJ,
online October 23, 2019.
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