Published ahead of print on August 16, 2007, doi:10.1164/rccm.200610-1467OC Am. J. Respir. Crit. Care Med., Volume 176, Number 10, November 2007, 983-987 A more recent version of this article appeared on November 15, 2007
Submitted on October 12, 2006 A Twin Study of Post-Traumatic Stress Disorder Symptoms and AsthmaRenee D Goodwin1*,1 Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA, 2 Vietnam Era Twin Registry, VA ERIC, Seattle, WA, USA, 3 Vietnam Era Twin Registry, VA ERIC, Seattle, WA, USA; Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, WA, USA * To whom correspondence should be addressed. E-mail: rdg66{at}columbia.edu.
Objective: To determine the association between post-traumatic stress disorder (PTSD) symptoms and asthma among adults; and to examine if this association is due to confounding by environmental and genetic factors. Method: Data were obtained from twins in the Vietnam Era Twin (VET) Registry, which includes veteran male twin pairs born between 1939 and 1956 who served during the Vietnam era (1965-1975). Measurements included a symptom scale for PTSD, history of a doctor diagnosis of asthma, and socio-demographic and health confounding factors. Co-twin control analytic methods used mixed effects logistic regression to account for the paired structure of the twin data and to examine the association between PTSD symptoms and asthma in all twins. Separate analyses were conducted within twin pairs and according to zygosity. Results: PTSD symptoms were associated with a significantly increased likelihood of asthma (ptrend<0.001) even after adjustment for confounding factors. Among all twins, those in the highest quartile of PTSD symptoms were 2.3 times as likely (95% confidence interval 1.4-3.7) to have asthma compared to those in the lowest quartile. These findings persist when examined within twin pairs and when stratified by zygosity. Conclusions: Symptoms of PTSD were associated with an elevated prevalence of asthma. Even after careful adjustment for familial/genetic factors and other potential confounding factors, an association between PTSD symptoms and asthma remains. Efforts to understand this comorbidity may be useful in identifying modifiable environmental risk factors contributing to this pattern and therefore in developing more effective prevention and intervention strategies. Key words: Asthma; PTSD; anxiety disorders; respiratory illness
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