Emily M. Hicks , Maria Niarchou , Slavina Goleva , Dia Kabir , Jessica Johnson , Keira J.A. Johnston , Julia Ciarcia , Gita A. Pathak , Jordan W. Smoller , Lea K. Davis , Caroline M. Nievergelt , Karestan C. Koenen , Laura M. Huckins , Karmel W. Choi , PGC/PsycheMERGE PTSD & Trauma EHR Working Group
{"title":"创伤后应激障碍在整个医学表型组中的共病特征","authors":"Emily M. Hicks , Maria Niarchou , Slavina Goleva , Dia Kabir , Jessica Johnson , Keira J.A. Johnston , Julia Ciarcia , Gita A. Pathak , Jordan W. Smoller , Lea K. Davis , Caroline M. Nievergelt , Karestan C. Koenen , Laura M. Huckins , Karmel W. Choi , PGC/PsycheMERGE PTSD & Trauma EHR Working Group","doi":"10.1016/j.bpsgos.2024.100337","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Previous epidemiological research has linked posttraumatic stress disorder (PTSD) with specific physical health problems, but the comprehensive landscape of medical conditions associated with PTSD remains uncharacterized. Electronic health records provide an opportunity to overcome clinical knowledge gaps and uncover associations with biological relevance that potentially vary by sex.</p></div><div><h3>Methods</h3><p>PTSD was defined among biobank participants (<em>N</em> = 145,959) in 3 major healthcare systems using 2 ICD code-based definitions: broad (≥1 PTSD or acute stress codes vs. 0; <em>n</em><sub>cases</sub> = 16,706) and narrow (≥2 PTSD codes vs. 0; <em>n</em><sub>cases</sub> = 3325). Using a phenome-wide association study design, we tested associations between each PTSD definition and all prevalent disease umbrella categories, i.e., phecodes. We also conducted sex-stratified phenome-wide association study analyses including a sex × diagnosis interaction term in each logistic regression.</p></div><div><h3>Results</h3><p>A substantial number of phecodes were significantly associated with PTSD<sub>Narrow</sub> (61%) and PTSD<sub>Broad</sub> (83%). While the strongest associations were shared between the 2 definitions, PTSD<sub>Broad</sub> captured 334 additional phecodes not significantly associated with PTSD<sub>Narrow</sub> and exhibited a wider range of significantly associated phecodes across various categories, including respiratory, genitourinary, and circulatory conditions. Sex differences were observed in that PTSD<sub>Broad</sub> was more strongly associated with osteoporosis, respiratory failure, hemorrhage, and pulmonary heart disease among male patients and with urinary tract infection, acute pharyngitis, respiratory infections, and overweight among female patients.</p></div><div><h3>Conclusions</h3><p>This study provides valuable insights into a diverse range of comorbidities associated with PTSD, including both known and novel associations, while highlighting the influence of sex differences and the impact of defining PTSD using electronic health records.</p></div>","PeriodicalId":72373,"journal":{"name":"Biological psychiatry global open science","volume":"4 5","pages":"Article 100337"},"PeriodicalIF":4.0000,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667174324000508/pdfft?md5=2b533b65c5a7d3328c7604a2ad768c02&pid=1-s2.0-S2667174324000508-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Comorbidity Profiles of Posttraumatic Stress Disorder Across the Medical Phenome\",\"authors\":\"Emily M. Hicks , Maria Niarchou , Slavina Goleva , Dia Kabir , Jessica Johnson , Keira J.A. Johnston , Julia Ciarcia , Gita A. Pathak , Jordan W. Smoller , Lea K. Davis , Caroline M. Nievergelt , Karestan C. Koenen , Laura M. Huckins , Karmel W. Choi , PGC/PsycheMERGE PTSD & Trauma EHR Working Group\",\"doi\":\"10.1016/j.bpsgos.2024.100337\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Previous epidemiological research has linked posttraumatic stress disorder (PTSD) with specific physical health problems, but the comprehensive landscape of medical conditions associated with PTSD remains uncharacterized. Electronic health records provide an opportunity to overcome clinical knowledge gaps and uncover associations with biological relevance that potentially vary by sex.</p></div><div><h3>Methods</h3><p>PTSD was defined among biobank participants (<em>N</em> = 145,959) in 3 major healthcare systems using 2 ICD code-based definitions: broad (≥1 PTSD or acute stress codes vs. 0; <em>n</em><sub>cases</sub> = 16,706) and narrow (≥2 PTSD codes vs. 0; <em>n</em><sub>cases</sub> = 3325). Using a phenome-wide association study design, we tested associations between each PTSD definition and all prevalent disease umbrella categories, i.e., phecodes. We also conducted sex-stratified phenome-wide association study analyses including a sex × diagnosis interaction term in each logistic regression.</p></div><div><h3>Results</h3><p>A substantial number of phecodes were significantly associated with PTSD<sub>Narrow</sub> (61%) and PTSD<sub>Broad</sub> (83%). While the strongest associations were shared between the 2 definitions, PTSD<sub>Broad</sub> captured 334 additional phecodes not significantly associated with PTSD<sub>Narrow</sub> and exhibited a wider range of significantly associated phecodes across various categories, including respiratory, genitourinary, and circulatory conditions. Sex differences were observed in that PTSD<sub>Broad</sub> was more strongly associated with osteoporosis, respiratory failure, hemorrhage, and pulmonary heart disease among male patients and with urinary tract infection, acute pharyngitis, respiratory infections, and overweight among female patients.</p></div><div><h3>Conclusions</h3><p>This study provides valuable insights into a diverse range of comorbidities associated with PTSD, including both known and novel associations, while highlighting the influence of sex differences and the impact of defining PTSD using electronic health records.</p></div>\",\"PeriodicalId\":72373,\"journal\":{\"name\":\"Biological psychiatry global open science\",\"volume\":\"4 5\",\"pages\":\"Article 100337\"},\"PeriodicalIF\":4.0000,\"publicationDate\":\"2024-05-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2667174324000508/pdfft?md5=2b533b65c5a7d3328c7604a2ad768c02&pid=1-s2.0-S2667174324000508-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Biological psychiatry global open science\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2667174324000508\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"NEUROSCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Biological psychiatry global open science","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2667174324000508","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NEUROSCIENCES","Score":null,"Total":0}
Comorbidity Profiles of Posttraumatic Stress Disorder Across the Medical Phenome
Background
Previous epidemiological research has linked posttraumatic stress disorder (PTSD) with specific physical health problems, but the comprehensive landscape of medical conditions associated with PTSD remains uncharacterized. Electronic health records provide an opportunity to overcome clinical knowledge gaps and uncover associations with biological relevance that potentially vary by sex.
Methods
PTSD was defined among biobank participants (N = 145,959) in 3 major healthcare systems using 2 ICD code-based definitions: broad (≥1 PTSD or acute stress codes vs. 0; ncases = 16,706) and narrow (≥2 PTSD codes vs. 0; ncases = 3325). Using a phenome-wide association study design, we tested associations between each PTSD definition and all prevalent disease umbrella categories, i.e., phecodes. We also conducted sex-stratified phenome-wide association study analyses including a sex × diagnosis interaction term in each logistic regression.
Results
A substantial number of phecodes were significantly associated with PTSDNarrow (61%) and PTSDBroad (83%). While the strongest associations were shared between the 2 definitions, PTSDBroad captured 334 additional phecodes not significantly associated with PTSDNarrow and exhibited a wider range of significantly associated phecodes across various categories, including respiratory, genitourinary, and circulatory conditions. Sex differences were observed in that PTSDBroad was more strongly associated with osteoporosis, respiratory failure, hemorrhage, and pulmonary heart disease among male patients and with urinary tract infection, acute pharyngitis, respiratory infections, and overweight among female patients.
Conclusions
This study provides valuable insights into a diverse range of comorbidities associated with PTSD, including both known and novel associations, while highlighting the influence of sex differences and the impact of defining PTSD using electronic health records.
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