Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Sep 1;182(5):451-8.
doi: 10.1093/aje/kwv066. Epub 2015 Aug 4.

Trauma, comorbidity, and mortality following diagnoses of severe stress and adjustment disorders: a nationwide cohort study

Jaimie L Gradus, Sussie Antonsen, Elisabeth Svensson, Timothy L Lash, Patricia A Resick, Jens Georg Hansen

Trauma, comorbidity, and mortality following diagnoses of severe stress and adjustment disorders: a nationwide cohort study

Jaimie L Gradus et al. Am J Epidemiol. .

Abstract

Longitudinal outcomes following stress or trauma diagnoses are receiving attention, yet population-based studies are few. The aims of the present cohort study were to examine the cumulative incidence of traumatic events and psychiatric diagnoses following diagnoses of severe stress and adjustment disorders categorized using International Classification of Diseases, Tenth Revision, codes and to examine associations of these diagnoses with all-cause mortality and suicide. Data came from a longitudinal cohort of all Danes who received a diagnosis of reaction to severe stress or adjustment disorders (International Classification of Diseases, Tenth Revision, code F43.x) between 1995 and 2011, and they were compared with data from a general-population cohort. Cumulative incidence curves were plotted to examine traumatic experiences and psychiatric diagnoses during the study period. A Cox proportional hazards regression model was used to examine the associations of the disorders with mortality and suicide. Participants with stress diagnoses had a higher incidence of traumatic events and psychiatric diagnoses than did the comparison group. Each disorder was associated with a higher rate of all-cause mortality than that seen in the comparison cohort, and strong associations with suicide were found after adjustment. This study provides a comprehensive assessment of the associations of stress disorders with a variety of outcomes, and we found that stress diagnoses may have long-lasting and potentially severe consequences.

Keywords: cohort studies; stress disorders; suicide; traumatic.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Cumulative incidence curves for traumatic experiences following stress diagnoses (International Classification of Diseases, Tenth Revision), Denmark, 1995–2011. A) Accidents; B) assaults; C) injuries from poisoning or external causes; and D) abuse, neglect, and other maltreatment.
Figure 2.
Figure 2.
Cumulative incidence curves for psychiatric diagnoses following stress diagnoses (International Classification of Diseases, Tenth Revision), Denmark, 1995–2011. A) Depression diagnoses; B) anxiety diagnoses; C) alcohol abuse and dependence diagnoses; and D) drug abuse and dependence diagnoses.
See this image and copyright information in PMC

References

    1. Janca A, Ustun TB, van Drimmelen J, et al. ICD-10 Symptom Checklist for Mental Disorders, Version 1.1. Geneva, Switzerland: Division of Mental Health, World Health Organization; 1994.
    1. Risser HJ, Hetzel-Riggin MD, Thomsen CJ, et al. PTSD as a mediator of sexual revictimization: the role of reexperiencing, avoidance, and arousal symptoms. J Trauma Stress. 2006;195:687–698. - PubMed
    1. Krause ED, Kaltman S, Goodman L, et al. Role of distinct PTSD symptoms in intimate partner reabuse: a prospective study. J Trauma Stress. 2006;194:507–516. - PubMed
    1. Kimerling R, Alvarez J, Pavao J, et al. Epidemiology and consequences of women's revictimization. Womens Health Issues. 2007;172:101–106. - PubMed
    1. Sandberg DA, Matorin AI, Lynn SJ. Dissociation, posttraumatic symptomatology, and sexual revictimization: a prospective examination of mediator and moderator effects. J Trauma Stress. 1999;121:127–138. - PubMed

Publication types

MeSH terms