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Effects of Chronic Posttraumatic Stress Disorder on Metabolic Risk, Quality of Life, and Stress Hormones in Aging Former Refugee Children

Muhtz, Christoph MD*; Godemann, Kathrin MD*; von Alm, Christine*; Wittekind, Charlotte*; Goemann, Christoph MD*; Wiedemann, Klaus MD*; Yassouridis, Alexander PhD; Kellner, Michael MD*

The Journal of Nervous and Mental Disease: September 2011 - Volume 199 - Issue 9 - p 646-652
doi: 10.1097/NMD.0b013e318229cfba
Original Articles

It is still unclear whether the association between traumatic stress and physical disease is mediated by posttraumatic stress disorder (PTSD). Therefore, we examined the long-term consequences of PTSD on cardiovascular risk, stress hormones, and quality of life in a sample of former refugee children who were severely traumatized more than six decades ago. In 25 subjects with chronic PTSD and 25 trauma-controlled subjects, we measured the variables of metabolic syndrome supplemented by the ankle-brachial index and highly sensitive C-reactive protein. Quality of life was assessed using the 36-item Short-Form Health Survey. Cortisol, adrenocorticotropin-releasing hormone (ACTH), and dehydroepiandrosterone (DHEA) were measured using the low-dose-dexamethasone suppression test. In addition, salivary cortisol was assessed at 8:00 a.m., 12:00 p.m., 4:00 p.m., and 8:00 p.m. We found a significant group effect between participants with and without PTSD regarding quality of life but not in any metabolic parameter including the ankle-brachial index or cortisol, ACTH, and DHEA in plasma before and after dexamethasone or salivary cortisol. The postulated association between traumatic stress and physical illness does not appear to be mediated by PTSD in this population. Nevertheless, the search for subgroups of PTSD patients with childhood traumatization leading to different metabolic and endocrine long-term consequences in aging PTSD patients is needed.

*Department of Psychiatry and Psychotherapy, University Hospital Hamburg-Eppendorf, Hamburg, Germany; and †Max Planck Institute of Psychiatry, Munich, Germany.

This study is part of the MD thesis of Ms. Kathrin Godemann.

The authors have no conflicts of interest.

Send reprint requests to Christoph Muhtz, MD, Dept. of Psychiatry and Psychotherapy, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. E-mail:

© 2011 Lippincott Williams & Wilkins, Inc.