Associations between lifetime potentially traumatic events and chronic physical conditions in the South African Stress and Health Survey: a cross-sectional study

dc.contributor.authorAtwoli, Lukoye
dc.contributor.authorPlatt, Jonathan M
dc.contributor.authorBasu, Archana
dc.contributor.authorWilliams, David R
dc.contributor.authorStein, Dan J
dc.contributor.authorKoenen, Karestan C
dc.date.accessioned2016-07-15T09:06:34Z
dc.date.available2016-07-15T09:06:34Z
dc.date.issued2016-07-07
dc.date.updated2016-07-07T18:03:10Z
dc.description.abstractBackground: This study examined the association between the type, and cumulative number of lifetime potentially traumatic events (PTEs), and chronic physical conditions, in a South African sample. PTE exposures have been associated with an increased risk for a wide range of chronic physical conditions, but it is unclear whether psychiatric disorders mediate this association. Given the established differences in trauma occurrence, and the epidemiology of posttraumatic stress disorder (PTSD) in South Africa relative to other countries, examining associations between PTEs and chronic physical conditions, particularly while accounting for psychiatric comorbidity is important. Methods: Data were drawn from the South African Stress and Health Study, a cross-sectional population-representative study of psychological and physical health of South African adults. Twenty-seven PTEs, based on the World Health Organization Composite International Diagnostic Interview Version 3.0, DSM-IV PTSD module were grouped into seven PTE types (war events, physical violence, sexual violence, accidents, unexpected death of a loved one, network events, and witnessing PTEs). Five clusters of physical conditions (cardiovascular, arthritis, respiratory, chronic pain, and other health conditions) were examined. Logistic regressions assessed the odds of reporting a physical condition in relation to type and cumulative number of PTEs. Cochran-Armitage test for trend was used to examine dose-response effect of cumulative PTEs on physical conditions. Results: After adjusting for sociodemographic variables and psychiatric disorders, respondents with any PTE had increased odds of all assessed physical conditions, ranging between 1.48 (95 % CI: 1.06–2.07) for arthritis and 2.07 (95 % CI: 1.57–2.73) for respiratory conditions, compared to those without PTE exposure. Sexual violence, physical violence, unexpected death of a loved one, and network PTEs significantly increased the odds of all or nearly all the physical conditions assessed. There was a dose-response relationship between number of PTEs and increased odds of all physical conditions. Conclusions: Results from this study, the first in an African general population, are consistent with other population-based studies; PTEs confer a broad-spectrum risk for chronic physical conditions, independent of psychiatric disorders. These risks increase with each cumulative PTE exposure. Clinically, comprehensive evaluations for risk of mental and physical health morbidities should be considered among PTE survivors.en_ZA
dc.identifier10.1186/s12888-016-0929-z
dc.identifier.apacitationAtwoli, L., Platt, J. M., Basu, A., Williams, D. R., Stein, D. J., & Koenen, K. C. (2016). Associations between lifetime potentially traumatic events and chronic physical conditions in the South African Stress and Health Survey: a cross-sectional study. <i>BMC Psychiatry</i>, http://hdl.handle.net/11427/20359en_ZA
dc.identifier.chicagocitationAtwoli, Lukoye, Jonathan M Platt, Archana Basu, David R Williams, Dan J Stein, and Karestan C Koenen "Associations between lifetime potentially traumatic events and chronic physical conditions in the South African Stress and Health Survey: a cross-sectional study." <i>BMC Psychiatry</i> (2016) http://hdl.handle.net/11427/20359en_ZA
dc.identifier.citationAtwoli, L., Platt, J. M., Basu, A., Williams, D. R., Stein, D. J., & Koenen, K. C. (2016). Associations between lifetime potentially traumatic events and chronic physical conditions in the South African Stress and Health Survey: a cross-sectional study. BMC psychiatry, 16(1):214. DOI: 10.1186/s12888-016-0929-z.en_ZA
dc.identifier.issn1471-244Xen_ZA
dc.identifier.ris TY - Journal Article AU - Atwoli, Lukoye AU - Platt, Jonathan M AU - Basu, Archana AU - Williams, David R AU - Stein, Dan J AU - Koenen, Karestan C AB - Background: This study examined the association between the type, and cumulative number of lifetime potentially traumatic events (PTEs), and chronic physical conditions, in a South African sample. PTE exposures have been associated with an increased risk for a wide range of chronic physical conditions, but it is unclear whether psychiatric disorders mediate this association. Given the established differences in trauma occurrence, and the epidemiology of posttraumatic stress disorder (PTSD) in South Africa relative to other countries, examining associations between PTEs and chronic physical conditions, particularly while accounting for psychiatric comorbidity is important. Methods: Data were drawn from the South African Stress and Health Study, a cross-sectional population-representative study of psychological and physical health of South African adults. Twenty-seven PTEs, based on the World Health Organization Composite International Diagnostic Interview Version 3.0, DSM-IV PTSD module were grouped into seven PTE types (war events, physical violence, sexual violence, accidents, unexpected death of a loved one, network events, and witnessing PTEs). Five clusters of physical conditions (cardiovascular, arthritis, respiratory, chronic pain, and other health conditions) were examined. Logistic regressions assessed the odds of reporting a physical condition in relation to type and cumulative number of PTEs. Cochran-Armitage test for trend was used to examine dose-response effect of cumulative PTEs on physical conditions. Results: After adjusting for sociodemographic variables and psychiatric disorders, respondents with any PTE had increased odds of all assessed physical conditions, ranging between 1.48 (95 % CI: 1.06–2.07) for arthritis and 2.07 (95 % CI: 1.57–2.73) for respiratory conditions, compared to those without PTE exposure. Sexual violence, physical violence, unexpected death of a loved one, and network PTEs significantly increased the odds of all or nearly all the physical conditions assessed. There was a dose-response relationship between number of PTEs and increased odds of all physical conditions. Conclusions: Results from this study, the first in an African general population, are consistent with other population-based studies; PTEs confer a broad-spectrum risk for chronic physical conditions, independent of psychiatric disorders. These risks increase with each cumulative PTE exposure. Clinically, comprehensive evaluations for risk of mental and physical health morbidities should be considered among PTE survivors. DA - 2016-07-07 DB - OpenUCT DO - 10.1186/s12888-016-0929-z DP - University of Cape Town J1 - BMC Psychiatry LK - https://open.uct.ac.za PB - University of Cape Town PY - 2016 SM - 1471-244X T1 - Associations between lifetime potentially traumatic events and chronic physical conditions in the South African Stress and Health Survey: a cross-sectional study TI - Associations between lifetime potentially traumatic events and chronic physical conditions in the South African Stress and Health Survey: a cross-sectional study UR - http://hdl.handle.net/11427/20359 ER - en_ZA
dc.identifier.urihttp://dx.doi.org/10.1186/s12888-016-0929-z
dc.identifier.urihttp://hdl.handle.net/11427/20359
dc.identifier.vancouvercitationAtwoli L, Platt JM, Basu A, Williams DR, Stein DJ, Koenen KC. Associations between lifetime potentially traumatic events and chronic physical conditions in the South African Stress and Health Survey: a cross-sectional study. BMC Psychiatry. 2016; http://hdl.handle.net/11427/20359.en_ZA
dc.languageengen_ZA
dc.language.rfc3066en
dc.publisherBioMed Centralen_ZA
dc.publisher.departmentDepartment of Psychiatry and Mental Healthen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsCreative Commons Attribution 4.0 International (CC BY 4.0)*
dc.rights.holderThe Author(s).
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_ZA
dc.sourceBMC Psychiatryen_ZA
dc.source.urihttp://bmcpsychiatry.biomedcentral.com/
dc.titleAssociations between lifetime potentially traumatic events and chronic physical conditions in the South African Stress and Health Survey: a cross-sectional studyen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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