High stress leads to autoimmune diseases

March 5, 2003 at 6:12 PM
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NEW YORK, March 5 (UPI) -- Vietnam War veterans with post-traumatic stress disorder seem more likely to develop autoimmune diseases such as rheumatoid arthritis or psoriasis, researchers reported Wednesday.

In an unpublished study to be presented Saturday at the American Psychosomatic Society meeting in Phoenix, Joseph Boscarino, a Vietnam veteran himself and senior scientist at the New York Academy of Medicine, examined the records of more than 4,000 men who served in the U.S. Army. Almost 2,000 of them had not served in Vietnam and nearly 2,500 had.

Boscarino found theater veterans -- those who saw combat in Vietnam and who had PTSD along with symptoms of either depression, hysteria, paranoia or schizophrenia -- were three times as likely to be suffering from an autoimmune disease. The most common illnesses were rheumatoid arthritis, psoriasis and hypothyroidism.

With a new war looming on the horizon and troops still in Afghanistan, concerns are increasing over the health effects of war experiences on veterans. Boscarino said there is a link between PTSD and autoimmune disorders, but the military is much better today at dealing with the psychological side of war than it was during the Vietnam era.

"Before the Vietnam War, there was no diagnosis of PTSD," Boscarino explained. Now, returning soldiers can seek PTSD care and social support. "What happened to Vietnam veterans probably won't happen again."

From data collected by the Centers for Disease Control and Prevention 15 years ago on the veterans in the study, Boscarino determined that 5 percent had co-morbid PTSD, or PTSD and another psychological disorder. Of those, 19 percent, or 23 people, developed an autoimmune disease.

The numbers are small and on the conservative side but statistically significant, Boscarino said. "These people are really suffering," he added.

"It's an interesting piece to the puzzle," Boscarino said, commenting on the results. "But we need more clinical study."

The analysis was limited by the type of data available, Boscarino explained, and some factors such as pesticide exposure were difficult to calculate. However, he said he thinks more veterans have autoimmune diseases stemming from PTSD than his results suggest.

Others are not so sure.

"Just because something is statistically significant doesn't mean it's clinically meaningful," said Dr. Robert Haley, chief of the epidemiology division at the University of Texas Southwestern Medical Center in Dallas.

The measures used to diagnose PTSD in the veterans 15 years ago are inaccurate, Haley said. This questionnaire method has been shown to produce a 20 percent false positive rate and has evolved into a more sophisticated and reliable technique today, he explained.

There have been a few studies suggesting a link between stress and autoimmune disease in the general population, Haley acknowledged, but he added that the evidence so far is weak.

"We don't see in PTSD and Gulf War Syndrome a higher number of infections," Haley commented. "If there is an immune problem, it will be very subtle. It will require more precise measurements."


(Reported by Christine Suh, UPI Science News, in Washington)

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