Risk factors for posttraumatic stress disorder: umbrella review
Citation: Tortella-Feliu M, Fullana MA, Pérez-Vigil A, et al. Risk factors for posttraumatic stress disorder: An umbrella review of systematic reviews and meta-analyses. Neuroscience & Biobehavioral Reviews. 2019;107:154-65.
Language: Abstract and full text available in EN.
Free to view: No.
Funding sources: Nothing noted.
What is this? In this umbrella review, the authors searched for systematic reviews and meta-analyses of risk factors for post-traumatic stress disorder (PTSD). They graded the evidence of association between each factor and PTSD. The authors searched up to August 2018 and did not restrict their searches by language. They found 33 publications that included 238 individual studies.
What was found? The review identified 130 factors, of which 57 showed a significant association with PTSD. Indigenous people of the Americas and women were at greater risk for PTSD than other people. A personal history of physical disease or a family history of a psychiatric disorder were also associated with a greater risk for PTSD.
Peri-trauma risk factors (such as cumulative exposure to potentially traumatic experiences, trauma severity, and being trapped during an earthquake) were less strongly associated with PTSD.
Post-trauma factors (e.g. familial support after the event) had less predictive power for PTSD than pre- or peri-trauma factors.
Implications: The authors concluded that many risk factors for post-traumatic stress disorder cannot be modified. Secondary prevention strategies should focus on risk assessment, understanding pathogenesis, and early intervention.
Other considerations: The authors of the review discuss their findings in the context of ethnicity, sex, and socioeconomic status.
This summary was prepared by Tuba Yavuz, checked by Surya Ramachandran, and finalized by William Summerskill.