Trauma, posttraumatic stress disorder, and incident chronic disease.

This article examines the associations between traumatic stress—including combat exposure, lifetime trauma exposure, posttraumatic stress disorder (PTSD) symptoms, and PTSD diagnosis—and the onset of chronic diseases among 3,696 post-9/11 U.S. veterans enrolled in the Veterans Integrated Service Networks 6 (VISN 6) Mental Illness Research, Education, and Clinical Center (MIRECC) Post-Deployment Mental Health Study. Using electronic health records (EHRs) over an average 13.3-year follow-up, the study found that PTSD symptoms and diagnoses were more strongly associated with incident chronic diseases—particularly cardiovascular disease (CVD), diabetes, and chronic pulmonary disease—than combat or trauma exposure alone. These associations persisted after adjusting for baseline clinical risk factors and other mental health diagnoses, while veterans with past PTSD showed reduced risk compared to those with current PTSD. The findings highlight the need for randomized clinical trials to determine whether PTSD treatment can reduce the risk of developing chronic diseases in this population.