Abstract:
Importance:Posttraumatic stress disorder (PTSD) is associated with an increased risk of type 2 diabetes mellitus (T2DM). Existing literature has adjusted for obesity in combination with other confounders, which does not allow estimating the contribution of obesity alone on the association of PTSD with incident T2DM. Objective:The current study was designed to determine if obesity accounted for the association between PTSD and incident T2DM. Design, Setting, and Participants:This cohort study used data from Veterans Health Administration medical records collected from patients with PTSD and without PTSD from 2008 to 2015. Patients were eligible for study inclusion if they were free of prevalent PTSD and T2DM for 12 months prior to index date. To estimate whether the association of PTSD and incident T2DM remained independent of obesity, Cox proportional hazard models were computed before and after adding obesity to the model and then further expanded by adding psychiatric disorders, psychotropic medications, physical conditions, smoking status, and demographics. Additional Cox models were computed to compare the risk of incident T2DM in patients with PTSD with and without obesity. Data analysis was completed from February 2018 to May 2018. Exposures:Two International Classification of Diseases, Ninth Revision (ICD-9) codes for PTSD in the same 12 months and obesity, defined by a body mass index of 30 or more or an ICD-9 code for obesity. Main Outcomes and Measures:Incident T2DM, as defined by ICD-9 codes. Results:Among 2204 patients without PTSD, the mean (SD) age was 47.7 (14.3) years; 1860 (84.4%) were men, 1426 (64.7%) were white, and 956 (43.4%) were married. Among 3450 patients with PTSD, the mean (SD) age was 42.8 (14.2) years; 2983 (86.5%) were men, 2238 (64.9%) were white, and 1525 (44.2%) were married. The age-adjusted association between PTSD and incident T2DM was significant (hazard ratio [HR], 1.33 [95% CI, 1.08-1.64]; P = .01), and after adding obesity to the model, this association was reduced and no longer significant (HR, 1.16 [95% CI, 0.94-1.43]; P = .18). Results of the full model, which included additional covariate adjustment, revealed no association between PTSD and incident T2DM (HR, 0.84 [95% CI, 0.64-1.10]; P = .19). Among patients with PTSD with obesity, the age-adjusted incidence of T2DM was 21.0 per 1000 person-years vs 5.8 per 1000 person-years in patients without obesity. In patients without PTSD, it was 21.2 per 1000 person-years for patients with obesity vs 6.4 per 1000 person-years in those without obesity. Conclusions and Relevance:In this study of patients who use the Veterans Health Administration for health care, obesity moderated the association between PTSD and incident T2DM. The incidence of T2DM in patients with PTSD who are not obese is similar to the national incidence rate in the United States. These results suggest PTSD is not likely to have a causal association with incident T2DM. Future research is needed to determine if PTSD remission can lead to weight loss and reduced T2DM incidence.
journal_name
JAMA Psychiatryjournal_title
JAMA psychiatryauthors
Scherrer JF,Salas J,Lustman PJ,van den Berk-Clark C,Schnurr PP,Tuerk P,Cohen BE,Friedman MJ,Norman SB,Schneider FD,Chard KMdoi
10.1001/jamapsychiatry.2018.2028subject
Has Abstractpub_date
2018-11-01 00:00:00pages
1189-1198issue
11eissn
2168-622Xissn
2168-6238pii
2695328journal_volume
75pub_type
杂志文章相关文献
JAMA Psychiatry文献大全abstract:Importance:Maturation of white matter fiber systems subserves cognitive, behavioral, emotional, and motor development during adolescence. Hazardous drinking during this active neurodevelopmental period may alter the trajectory of white matter microstructural development, potentially increasing risk for developing alcoh...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2020.4064
更新日期:2020-12-30 00:00:00
abstract:Importance:The onset of adult psychopathologic disorders can be traced to behavioral or emotional symptoms observed in childhood, which could be targeted in early interventions to prevent future mental disorders. The network perspective is a novel conceptualization of psychopathologic disorders that could help to ident...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2018.2119
更新日期:2018-11-01 00:00:00
abstract:IMPORTANCE:Twin-family studies have shown that parent-child resemblance on substance use disorders and antisocial behavior can be accounted for by the transmission of a general liability to a spectrum of externalizing disorders. Most studies, however, include only biological parents and offspring, which confound geneti...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2013.258
更新日期:2013-10-01 00:00:00
abstract:Importance:Publicly funded mental health services play an important role in addressing co-occurring mental health problems in children with autism spectrum disorder (ASD); however, therapists report lacking training to effectively serve this complex population. Objective:To test the effectiveness of training community...
journal_title:JAMA psychiatry
pub_type: 杂志文章,随机对照试验
doi:10.1001/jamapsychiatry.2019.0011
更新日期:2019-06-01 00:00:00
abstract:IMPORTANCE:Patients with attention-deficit/hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD) share impaired inhibitory control. However, it is unknown whether impairments are mediated by shared or disorder-specific neurostructural and neurofunctional abnormalities. OBJECTIVE:To establish shared and...
journal_title:JAMA psychiatry
pub_type: 杂志文章,meta分析
doi:10.1001/jamapsychiatry.2016.0700
更新日期:2016-08-01 00:00:00
abstract:IMPORTANCE:Psychosis-risk studies have examined help-seeking adolescents and young adults. Population-based studies evaluating psychotic symptoms and neurocognitive performance across childhood are needed for "growth charting" cognitive development. We hypothesized that psychosis spectrum youths have delayed neurocogni...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2013.4190
更新日期:2014-04-01 00:00:00
abstract:IMPORTANCE:Despite its high prevalence and morbidity, the underlying neural basis of major depressive disorder (MDD) in youth is not well understood. OBJECTIVES:To identify in youth diagnosed as having MDD the most reliable neural abnormalities reported in existing functional neuroimaging studies and characterize thei...
journal_title:JAMA psychiatry
pub_type: 杂志文章,meta分析
doi:10.1001/jamapsychiatry.2015.1376
更新日期:2015-10-01 00:00:00
abstract:Importance:Bipolar disorder (BD) overlaps schizophrenia in its clinical presentation and genetic liability. Alternative approaches to patient stratification beyond current diagnostic categories are needed to understand the underlying disease processes and mechanisms. Objective:To investigate the association between co...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2017.3485
更新日期:2018-01-01 00:00:00
abstract:IMPORTANCE:Compulsory admissions, defined as admissions against the will of the patient (according to local judicial procedures), have a strong effect on psychiatric patients. In several Western countries, the rate of such admissions is tending to rise. Its reduction is urgently needed. OBJECTIVE:To establish which in...
journal_title:JAMA psychiatry
pub_type: 杂志文章,meta分析,评审
doi:10.1001/jamapsychiatry.2016.0501
更新日期:2016-07-01 00:00:00
abstract:Importance:Identifying genes and proteins for cognitive resilience (ie, targets that may be associated with slowing or preventing cognitive decline regardless of the presence, number, or combination of common neuropathologic conditions) provides a complementary approach to developing novel therapeutics for the treatmen...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2020.1807
更新日期:2020-07-01 00:00:00
abstract:Importance:Autism spectrum disorder (ASD) is a highly prevalent disorder, and community psychiatrists are likely to treat many individuals with ASD during their clinical practice. This clinical case challenge describes a routine evaluation of irritability and self-injury in a preschool-aged child who meets the criteria...
journal_title:JAMA psychiatry
pub_type: 杂志文章,评审
doi:10.1001/jamapsychiatry.2017.4685
更新日期:2018-05-01 00:00:00
abstract:IMPORTANCE:Anorexia nervosa (AN) is a serious disorder with high rates of morbidity and mortality. Family-based treatment (FBT) is an evidence-based therapy for adolescent AN, but less than half of those who receive this approach recover. Hence, it is important to identify other approaches to prevent the development of...
journal_title:JAMA psychiatry
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1001/jamapsychiatry.2014.1025
更新日期:2014-11-01 00:00:00
abstract:Importance:Suicide deaths are a leading cause of maternal mortality in the US, yet the prevalence and trends in suicidality (suicidal ideation and/or intentional self-harm) among childbearing individuals remain poorly described. Objective:To characterize trends in suicidality among childbearing individuals. Design, S...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2020.3550
更新日期:2020-11-18 00:00:00
abstract:Importance:Antipsychotic medications are commonly used to treat nonpsychotic disruptive behavioral disorders in youths. Objective:To characterize the metabolic effects of first exposure to antipsychotics in youths using criterion standard assessments of body composition and insulin sensitivity. Design, Setting, and P...
journal_title:JAMA psychiatry
pub_type: 杂志文章,随机对照试验
doi:10.1001/jamapsychiatry.2018.1088
更新日期:2018-08-01 00:00:00
abstract:Importance:Suicide is a public health problem, with multiple causes that are poorly understood. The increased focus on combining health care data with machine-learning approaches in psychiatry may help advance the understanding of suicide risk. Objective:To examine sex-specific risk profiles for death from suicide usi...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2019.2905
更新日期:2020-01-01 00:00:00
abstract:IMPORTANCE:Cocaine addiction is associated with altered resting-state functional connectivity among regions of the mesocorticolimbic dopamine pathways. Methylphenidate hydrochloride, an indirect dopamine agonist, normalizes task-related regional brain activity and associated behavior in cocaine users; however, the neur...
journal_title:JAMA psychiatry
pub_type: 杂志文章,随机对照试验
doi:10.1001/jamapsychiatry.2013.1129
更新日期:2013-08-01 00:00:00
abstract:Importance:Although several strategies of repetitive transcranial magnetic stimulation (rTMS) have been investigated as treatment of major depressive disorder (MDD), their comparative efficacy and acceptability is unknown. Objective:To establish the relative efficacy and acceptability of the different modalities of rT...
journal_title:JAMA psychiatry
pub_type: 杂志文章,meta分析,评审
doi:10.1001/jamapsychiatry.2016.3644
更新日期:2017-02-01 00:00:00
abstract:Importance:Recent estimates suggest that more than 50% of all deaths worldwide are currently attributable to inflammation-related diseases. Psychosocial interventions may represent a potentially useful strategy for addressing this global public health problem, but which types of interventions reliably improve immune sy...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2020.0431
更新日期:2020-10-01 00:00:00
abstract:IMPORTANCE:Community functioning is a core component of the functional deficits in schizophrenia, yet little systematic research on the origins of these functional deficits has been performed. OBJECTIVES:To examine 3 key domains of community functioning--social activity, independent behavior, and functioning in school...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2015.2253
更新日期:2016-01-01 00:00:00
abstract:IMPORTANCE:Depression and obesity are 2 prevalent disorders that have been repeatedly shown to be associated. However, the mechanisms and temporal sequence underlying this association are poorly understood. OBJECTIVE:To determine whether the subtypes of major depressive disorder (MDD; melancholic, atypical, combined, ...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2014.411
更新日期:2014-08-01 00:00:00
abstract:Importance:Growing evidence suggests that prescription opioid use affects depression and anxiety disorders; however, observational studies are subject to confounding, making causal inference and determining the direction of these associations difficult. Objective:To investigate the potential bidirectional associations...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2020.3554
更新日期:2020-11-11 00:00:00
abstract:IMPORTANCE:Cocaine dependence is a significant public health problem, yet no validated pharmacological treatment exists. The potent γ-aminobutyric acid (GABA)ergic medication vigabatrin has previously been shown to be effective in a double-blind single-site study conducted in Mexico. OBJECTIVE:To evaluate the safety a...
journal_title:JAMA psychiatry
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1001/jamapsychiatry.2013.872
更新日期:2013-06-01 00:00:00
abstract:IMPORTANCE:Although depression and type 2 diabetes mellitus (DM) may independently increase the risk for dementia, no studies have examined whether the risk for dementia among people with comorbid depression and DM is higher than the sum of each exposure individually. OBJECTIVE:To examine the risk for all-cause dement...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2015.0082
更新日期:2015-06-01 00:00:00
abstract::IMPORTANCE—Suicide can be viewed as an escape from unendurable punishment at the cost of any future rewards. Could faulty estimation of these outcomes predispose to suicidal behavior? In behavioral studies, many of those who have attempted suicide misestimate expected rewards on gambling and probabilistic learning tas...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2013.75
更新日期:2013-10-01 00:00:00
abstract:Importance:Several psychotherapy protocols have been evaluated as adjuncts to pharmacotherapy for patients with bipolar disorder, but little is known about their comparative effectiveness. Objective:To use systematic review and network meta-analysis to compare the association of using manualized psychotherapies and th...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2020.2993
更新日期:2020-10-14 00:00:00
abstract:Importance:There has been limited systematic examination of whether risk of suicide attempt (SA) among US Army soldiers is associated with time-related deployment variables, such as time in service before first deployment, duration of first deployment, and dwell time (DT) (ie, length of time between deployments). Obje...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2018.0296
更新日期:2018-06-01 00:00:00
abstract:Importance:More than 30 million people live with a stroke diagnosis worldwide. Depression after stroke is frequent, and greater knowledge of associated risk factors and outcomes is needed to understand the etiology and implications of this disabling complication. Objectives:To examine whether the incidence of and risk...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2016.1932
更新日期:2016-10-01 00:00:00
abstract:IMPORTANCE:Animal data suggest that chronic stress is associated with a reduction in norepinephrine transporter (NET) availability in the locus coeruleus. However, it is unclear whether such models are relevant to posttraumatic stress disorder (PTSD), which has been linked to noradrenergic dysfunction in humans. OBJEC...
journal_title:JAMA psychiatry
pub_type: 杂志文章,收录出版
doi:10.1001/jamapsychiatry.2013.399
更新日期:2013-11-01 00:00:00
abstract::In 1893 and 1896, in his fourth and fifth textbook editions, Emil Kraepelin brought together 3 syndromes to form the first and second of his 2 prequels to dementia praecox (DP), a definitive version of which he would propose in his 1899 sixth textbook edition. These syndromes, which would become hebephrenic DP, catato...
journal_title:JAMA psychiatry
pub_type: 杂志文章
doi:10.1001/jamapsychiatry.2020.1266
更新日期:2020-06-10 00:00:00
abstract:IMPORTANCE:Cigarette smoking leads to upregulation of nicotinic acetylcholine receptors (nAChRs) in the human brain, including the common α4β2* nAChR subtype. While subjective aspects of tobacco dependence have been extensively examined as predictors of quitting smoking with treatment, no studies to our knowledge have ...
journal_title:JAMA psychiatry
pub_type: 杂志文章,随机对照试验
doi:10.1001/jamapsychiatry.2014.138
更新日期:2014-07-01 00:00:00