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Stress related disorders and physical health

BMJ 2019; 367 doi: (Published 23 October 2019) Cite this as: BMJ 2019;367:l6036

Linked Research

Stress related disorders and subsequent risk of life threatening infections

  1. Jonathan I Bisson, professor in psychiatry
  1. Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff CF24 4HQ, UK
  1. bissonji{at}
  2. Research, doi:10.1136/bmj.l5784

PTSD is associated with diverse physical conditions

Post-traumatic stress disorder (PTSD) and other stress related disorders are common and associated with considerable distress, psychiatric comorbidity, and reduced functioning.1 Less well recognised is the substantial physical comorbidity associated with these conditions, highlighting an ongoing tendency to a dualistic view of mind and body.2 Song and colleagues’ (doi:10.1136/bmj.l5784) concerning finding that people with stress related disorders are at significantly heightened risk of life threatening infections3 challenges this notion and adds to previous research suggesting overlapping mechanistic pathways between mental and physical health.4

PTSD is strongly associated with poor physical health. A recent summary of reviews5 identified increasingly robust evidence confirming a link between PTSD and various physical conditions, including gastrointestinal, dermatological, musculoskeletal, neurological, and cardiorespiratory disorders. One meta-analysis found a 27% increase in the rate of cardiac events or cardiac specific mortality in people with PTSD after adjusting for depression and personal, clinical, and psychosocial factors.6 In a previous study, Song and colleagues found that people with PTSD had a …

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