Table 1 Characteristics of 30 included studies
Authors and year | Setting, Study or database | Sample size (n) and PTSD % | Age at baseline (mean (SD) or range), female % | Follow-up years | Type of trauma | PTSD assessment | PTSD-mortality association* | Cause of death | Adjustment |
|---|---|---|---|---|---|---|---|---|---|
Bohnert et al., [37] | US, Prospective, VA NPCD | 3,291,891, 6.27% | 75.4% between 40–59 yrs, F: 10% | 6 yrs | War | Current diagnosis, ICD-9-CM | ↑ risk | External (accidental overdose) | Age, sex, other |
Boscarino et al., 34 | US, Prospective, National Personnel Records Centre | 15,288, 6.87% | 13-20.4% ≥ 40 yrs: F: 0% | 16 yrs | War | Current diagnosis, RTI – PTSD, DIS – III PTSD, and Combat Exposure Scale | ↑ risk | All-cause, external, CVD and cancer | Age, sex, other |
Bramsen et al., [38] | Netherlands, Prospective, registries of 9 cities | 1448, 4.49% | 67.3 (2.9) yrs, F: 38% | 10 yrs | War (civilians) | Current symptoms, SRIP based on DSM-IV | ↑ risk | All-cause | Age, sex, other |
Bullman & Kang, [48] | US, Prospective, Agent Orange Registry | 16,257, 26.12% | 31 yrs, F: 0% | 4.2–5.2 yrs | War | Current diagnosis, DSM-III and DSM-III-R | ↑ risk | All-cause, cancer, circulatory & digestive, and external | Age, sex, other |
Cho et al., [39] | US, Prospective, VHA | 80s subsample: 665,249 (total n = 721,588), 1.7% | 84 (3.3) yrs, F: 2% | 5 yrs | War | Current diagnosis ICD-9-CM | ↓ risk | All-cause | Unclear |
Chwastiak et al., [57] | US, Prospective, VA administrative records | 559,985, 6.2% | 64.1 (12.9) yrs F: 4.1% | 9 yrs | War | Current diagnosis, ICD-9-CM | Null Subsample: n = 483,091 | All-cause | Age, sex, psychiatric disorders, other |
Clark et al., [62] | US, Prospective, VA NPCD, CMS, SPAN & MDR | 951,018, 50% | 62.9 (8.30)-63.6 (7.4) yrs, F: 5.6–6.3% | 5.8 yrs | War | Current diagnosis, ICD-9 | ↑ risk | External (unintentional drug overdose) | Age, sex, psychiatric disorders, other |
Flood et al., [40] | US, Prospective, VA PTSD clinic & VES databases | 5248, 22.41% | 37.84–50.46 yrs, F: 0% | 12–15 yrs | War | Current diagnosis, DSM-III-R and DIS-III | ↑ risk | All-cause | Age, sex, other |
Giesinger et al., [41] | US, Prospective, The WTC Health Registry | 63,666, 10.51% | 40.4 (10.4), F: 38.9% | 13 yrs | Terrorist attack | Current symptoms, PCL-17 | ↑ risk | All-cause, CVD, external | Age, sex, depression, other |
Gradus et al., [59] | Denmark, Prospective, National medical & social registers | 512,101, 0.74% | 47.8–54% between 31–55 yrs, F: 60-60.1% | 16 yrs | None specified | Current diagnosis, ICD-10 | ↑ risk | All-cause | Depression, other |
Kilbourne et al., [55] | US, Prospective, VHA | Total unknown, PTSD: 281,545 | Age at death: 65 (12.4) yrs (all-cause), 66.4 (12.3) (CVD), F % unknown | 1 yr | War | Unknown | ↑ risk YPLLs: All-cause 18.4 ± 8.4 (18.1–18.7), CVD: 17.4 ± 8.1 (6.9–17.9) | All-cause and CVD | Age, sex |
Kim et al., [23] | Korea, Prospective, Korean National Health Insurance Database | 214,996, 25% | 49.86 (11.30)-50.31 (11.54) yrs, F: 64.6% | 6–7 yrs | None specified | Current diagnosis, ICD-10 | ↑ risk | CVD | Age, sex, depression, other |
Kimbrell et al., [42] | US, Prospective, VISN 16 data warehouse | Without purple heart subsample: 8603 (total n = 10,255), 41.76% | 73.7–73.8 yrs, F: 0.8–1.1% | 2 yrs | War | Current diagnosis, ICD-9-CM | ↑ risk | All-cause | Age, sex, other |
Kinder et al., [43] | US, Prospective, ACQUIP data repository | Without depression subsample: 25,077 (total n = 35,715), 13.39% | 58 (13) – 64 (12) yrs, F: 0.5–3.8% | 2 yrs | War | Current diagnosis, ICD-9-CM | Null | All-cause | Age, sex, depression, other |
Lewandowski-Romps et al., [56] | US, Case-control, Army and Department of Defense administrative records | Cases: 1080, controls: 30,939,614, PTSD unknown | Age unknown, F: 5.6–13.8% | 5 yrs | War | Current diagnosis, ICD-9-CM | ↑ risk Never deployed OR: 2.8 (1.3–6.1) | External (accidental) | Age, sex, depression, other |
Li et al., [44] | Japan, Prospective, The Japan Gerontological Evaluation Study | 2,965, 25.2% | 73.4 (6.2) yrs, F: 54.7% | 3.3 yrs | Natural disaster | Current symptoms, SQD-P | Null | All-cause | Age, sex, depression, other |
Meier et al., [60] | Denmark, Prospective, population registries | 3,270,650, PTSD unknown | Age unknown, F % unknown | 9.7 yrs | None specified | Lifetime diagnosis, ICD-10 | ↑ risk | All-cause, external, natural causes | Age, sex, depression, other |
Mollica et al., [49] | Croatia, Prospective, Bosnian refugees living in camps | 528, 26.3% | 33.7% between 35–54 yrs, F: 58.4% | 3 yrs | War (civilians) | Current diagnosis, DSM-IV and HTQ | Null | All-cause | None |
Roberts et al., [45] | US, Prospective, Nurses’ Health Study II | Without depression + 4–5 PTSD symptoms subsample: 13,249 (total n = 51,602), 32.90% | 53.2 (4.7)-53.3 (4.6), F: 100% | 9 yrs | None specified | Current symptoms, Short Screening Scale for DSM-IV PTSD | Null | All-cause | Age, sex, depression, other |
Schlenger et al., [46] | US, Prospective, National Vietnam Veterans Study | Theatre veteran subsample: 1632 (total n = 2348), 10.66% | 41.5 yrs, F: 26.5% | 24 yrs | War | Current symptoms, Survey assessment, DSM-III (clinical subsample) | ↑ risk | All-cause | Age |
Solomon et al., [54] | Lebanon, Prospective, war veterans | 680, PTSD unknown | 29.4 (9.2) − 32.7 (9.3) yrs, F: 0% | 33 yrs | War | Current symptoms, PTSD Inventory based on DSM-III | Null | All-cause | Sex, depression, other |
Song et al., [21] | Sweden, Prospective, The National Patient Register | Population based cohort: 1,460,731, (total n = 1,881,793), 0.8% | 37.2 (14.2) yrs, F: 61.7% | 8 yrs | None specified | Current diagnosis, ICD-9 or ICD-10 | ↑ risk | Infection | Age, sex, psychiatric disorders, other |
Szymanski et al., [63] | US, Retrospective, VHA | 8,812,373, 9.8% | 55–74 yrs: 42.19%, F: 11.7% | 1 yr | War | Current diagnosis, ICD-9 or ICD-10 | ↑ risk | All-cause | Age, sex, other |
Tian et al., [22] | Sweden, Prospective, The National Patient Register | Population based cohort: 1,910,873 (total n = 2,409,931), 0.8% | 37.3 (14.6) yrs, F: 62.2% | 9–10 yrs | None specified | Current diagnosis, ICD-9 or ICD-10 | ↑ risk | All-cause | Age, sex, psychiatric disorders, other |
Tian et al., [22] | Sweden, Prospective, The National Patient Register | Population based cohort: 1,644,414 (total n = 2,080,339), 0.8% | 36.6 (14.2)- 36.2 (14), F: 62% | 7–8 yrs | None specified | Current diagnosis, ICD-9 or ICD-10 | ↑ risk | Cancer | Age, sex, other |
Trivedi et al., [50] | US, Prospective, VHA’s corporate data warehouse | 4,461,208, 9.3% | 55.9 (14.2) yrs, F: 7.9% | 1 yr | War | Current diagnosis, ICD-9, | ↓ risk | All-cause | Age, sex, other |
Vaillant et al., [53] | US, Prospective, Harvard University | 244, PTSD unknown | 19 yrs, F: 0% | 70 yrs | War | Current symptoms, Interview & symptoms based on DSM-III, | ↑ risk. F(2, 241) = 4.0, P = 0.019 | All-cause | Sex, other |
Welch et al., [51] | US, Prospective, WTC health registry | 1193, 24.5% | 48.8% between 45–64 yrs, F: 45.2% | 8 yrs | Terrorist attack | Current symptoms, PCL-17 | ↑ risk | External (alcohol & drug related) | Sex, other |
Wolf et al., [52] | US, Prospective, VHA trauma-exposed veterans & partners | 339, 69% | 52.58 (10.65) yrs, F: 13.0% | 6.5 yrs | War | Lifetime symptoms, DSM-IV | Null, subsample: n = 241 | All-cause | Age, sex, other |
Zohar et al., [47] | Israel, Prospective paired-sample, MOD | 4914, 50% | ~ 47 yrs, F: 0% | > 9 yrs | War | Current diagnosis, DSM-IV | Null, subsample: n = 4889 | All-cause | Age, sex, other |