PTSD with depression may significantly increase risk of early death in women

Boston, MA – Women with post-traumatic stress disorder (PTSD) and depression have an almost fourfold greater risk of early death from cardiovascular disease, respiratory disease, type 2 diabetes, accidents, suicide, and other causes than women without trauma exposure or depression, according to a large long-term study conducted by researchers at Harvard T.H. Chan School of Public Health.

“The study examines longevity–in a way, the ultimate health outcome–and the findings strengthen our understanding that mental and physical health are tightly interconnected,” said Andrea Roberts, lead author of the study and a senior research scientist in the Department of Environmental Health. “This is particularly salient during the pandemic, which is exposing many Americans and others across the world to unusual stress while at the same time reducing social connections, which can be powerfully protective for our mental health.”

The study, which is the first study of co-occurring PTSD and depression in a large population of civilian women, will be published online December 4, 2020 in

JAMA Network Open

. Previous research on PTSD and depression has primarily focused on men in the military.

Roberts and her colleagues studied more than 50,000 women at midlife (ages 43 to 64 years) and found that women with both high levels of PTSD and depression symptoms were nearly four times more likely to die from nearly every major cause of death over the following nine years than women who did not have depression and had not experienced a traumatic event.

The researchers examined whether health risk factors such as smoking, exercise, and obesity might explain the association between PTSD and depression and premature death, but these factors only explained a relatively small part. This finding suggests that other factors, such as the effect of stress hormones on the body, may account for the higher risk of early death in women with the disorders.

Treatment of PTSD and depression in women with symptoms of both disorders may reduce their substantial increased risk of mortality, the researchers said.

“These findings provide further evidence that mental health is fundamental to physical health–and to our very survival. We ignore our emotional well-being at our peril,” said Karestan Koenen, senior author of the study and professor of psychiatric epidemiology in the Department of Epidemiology and Department of Social and Behavioral Sciences.

Other Harvard Chan School authors included Laura Kubzansky, Lori Chibnik, and Eric Rimm.

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This study was supported by the National Institutes of Health (NIH R01MH101269-07 and U01 CA176726).

“Association of posttraumatic stress and depressive symptoms with mortality in women: A 9-year prospective cohort study,” Andrea L. Roberts, Laura D. Kubzansky, Lori Chibnik, Eric B. Rimm, Karestan C. Koenen, JAMA Network Open, online December 4, 2020, DOI: 10.1001/jamanetworkopen.2020.27935

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Harvard T.H. Chan School of Public Health brings together dedicated experts from many disciplines to educate new generations of global health leaders and produce powerful ideas that improve the lives and health of people everywhere. As a community of leading scientists, educators, and students, we work together to take innovative ideas from the laboratory to people’s lives–not only making scientific breakthroughs, but also working to change individual behaviors, public policies, and health care practices. Each year, more than 400 faculty members at Harvard Chan School teach 1,000-plus full-time students from around the world and train thousands more through online and executive education courses. Founded in 1913 as the Harvard-MIT School of Health Officers, the School is recognized as America’s oldest professional training program in public health.