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.
What is this?
Posttraumatic stress disorder (PTSD) is a mental health condition experienced by some individuals who have survived traumatic events, such as earthquakes.
In this umbrella review, the authors searched for systematic reviews and meta-analyses of PTSD risk factors and assessed and graded the evidence of the association between each factor and PTSD. They did not restrict their searches by language of publication and did the search up to 31 August 2018. They included 33 systematic reviews/meta-analyses, which contained 238 individual studies. They classified 85% of the systematic reviews/meta-analyses as having high or moderate quality.
What was found?
A total of 130 potential risk factors were identified, of which 57 showed a significant association with PTSD.
Robust risk factors for developing PTSD were being female, being indigenous people of the Americas, history of physical disease and family history of psychiatric disorder.
Risk factors that were less robust, but still highly suggestive, included cumulative exposure to potentially traumatic experiences, trauma severity and being trapped during an earthquake.
Post-trauma factors (e.g. familial support after the event) had less predictive power than pre- or peri-trauma factors.
Implications: The authors concluded that although many of these risk factors cannot be modified, secondary prevention strategies should focus on risk assessment, understanding pathogenesis and early intervention.
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