Evidence for PTSD as a Systemic Disorder

Abstract

Post-traumatic stress disorder (PTSD) has a prevalence of 6.8 % among the American population and an even greater prevalence among combat veterans. The conventional view of PTSD has been as a psychological adjustment disorder characterized by depression and anxiety in response to stressful circumstances. Recently, however, it has become apparent that it is much more than a psychological adjustment disorder. This began with the appreciation of the fact that dementia is much more common in PTSD, suggesting neurological changes in the disorder. There is now evidence for psychiatric changes (e.g., mood disorders, substance use and abuse), cardiovascular changes, autoimmune changes (e.g.,rheumatoid arthritis), tumorigenic changes, etc. The goal of this chapter is to briefly review the evidence for systemic involvement in preparation for subsequent chapters that will focus on detailed discussions of each organ system.