TY - JOUR
T1 - The relationship between post-traumatic stress disorder, depression and cardiovascular disease in an American Indian tribe
AU - Sawchuk, Craig N.
AU - Roy-Byrne, Peter
AU - Goldbeg, Jack
AU - Manson, Spero
AU - Noonan, Carolyn
AU - Beals, Janette
AU - Buchwald, Dedra
AU - Big Crow, Cecelia K.
AU - Chambers, Buck
AU - Christensen, Michelle L.
AU - Dillard, Denise A.
AU - DuBray, Karen
AU - Espinoza, Paula A.
AU - Fleming, Candace M.
AU - Frederick, Ann Wilson
AU - Gone, Joseph
AU - Gurley, Diana
AU - Jervis, Lori L.
AU - Jim, Shirlene M.
AU - Kaufman, Carol E.
AU - Keane, Ellen M.
AU - Klein, Suzell A.
AU - Lee, Denise
AU - McNulty, Monica C.
AU - Middlebrook, Denise L.
AU - Moore, Laurie A.
AU - Nez, Tilda D.
AU - Norton, Ilena M.
AU - Novins, Douglas K.
AU - O'Nell, Theresa
AU - Orton, Heather D.
AU - Randall, Carlette J.
AU - Sam, Angela
AU - Shore, James H.
AU - Simpson, Sylvia G.
AU - Spicer, Paul
AU - Yazzie, Lorette L.
PY - 2005/12
Y1 - 2005/12
N2 - Background. Empirical findings suggest that psychiatric illness is associated with cardiovascular disease (CVD). The purpose of this study was to compare the strength of the association of lifetime post-traumatic stress disorder (PTSD) and lifetime major depression on CVD among Northern Plains American Indians. Method. A total of 1414 participants aged 18-57 years completed a structured interview that assessed psychiatric diagnoses, alcohol abuse/ dependence, self-reported CVD, and traditional CVD risk factors including age, sex, education, diabetes, high blood pressure, and smoking. Logistic regression analyses compared the odds ratios of CVD in participants with and without diagnosed PTSD or major depression. Results. The rates of lifetime PTSD and major depression were 15% and 8% respectively. CVD was more commonly reported by participants with PTSD than by those without PTSD (12% v. 5%, ν p≤0.01). Likewise, more participants with major depression reported CVD than did their non-depressed counterparts (14% ν. 6%, p≤0.05). PTSD was significantly associated with CVD even after controlling for traditional CVD risk factors and major depression (odds ratio 2.0, confidence interval 1.1-3.8). In contrast, the association of major depression with CVD was not significant after accounting for both traditional risk factors and PTSD. Conclusions. Rates of PTSD are high in American Indian communities. Rising CVD rates in this population may be better understood if PTSD is considered along with other traditional risk factors. Future research should examine the association and mechanisms of PTSD and CVD prospectively. Such data could lead to more effective CVD prevention efforts for American Indians.
AB - Background. Empirical findings suggest that psychiatric illness is associated with cardiovascular disease (CVD). The purpose of this study was to compare the strength of the association of lifetime post-traumatic stress disorder (PTSD) and lifetime major depression on CVD among Northern Plains American Indians. Method. A total of 1414 participants aged 18-57 years completed a structured interview that assessed psychiatric diagnoses, alcohol abuse/ dependence, self-reported CVD, and traditional CVD risk factors including age, sex, education, diabetes, high blood pressure, and smoking. Logistic regression analyses compared the odds ratios of CVD in participants with and without diagnosed PTSD or major depression. Results. The rates of lifetime PTSD and major depression were 15% and 8% respectively. CVD was more commonly reported by participants with PTSD than by those without PTSD (12% v. 5%, ν p≤0.01). Likewise, more participants with major depression reported CVD than did their non-depressed counterparts (14% ν. 6%, p≤0.05). PTSD was significantly associated with CVD even after controlling for traditional CVD risk factors and major depression (odds ratio 2.0, confidence interval 1.1-3.8). In contrast, the association of major depression with CVD was not significant after accounting for both traditional risk factors and PTSD. Conclusions. Rates of PTSD are high in American Indian communities. Rising CVD rates in this population may be better understood if PTSD is considered along with other traditional risk factors. Future research should examine the association and mechanisms of PTSD and CVD prospectively. Such data could lead to more effective CVD prevention efforts for American Indians.
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U2 - 10.1017/S0033291705005751
DO - 10.1017/S0033291705005751
M3 - Article
C2 - 16300692
AN - SCOPUS:27944454797
SN - 0033-2917
VL - 35
SP - 1785
EP - 1794
JO - Psychological medicine
JF - Psychological medicine
IS - 12
ER -