King's College London

3

Joni Coleman

OFHS240151

The study aims to identify people who have experienced post-traumatic stress disorder, using hospital records. We will use several approaches to doing this, differing in the specific diagnoses reported (PTSD vs adjustment disorder) and the number of times diagnoses have been reported (once vs multiple times). We will also examine if clinical and demographic variables differ between the groups identified by these methods, and if these groups differ in their genetic risk for PTSD and related conditions. Post-traumatic stress disorder (PTSD) is a distressing psychiatric condition that emerges in some individuals following a life-threatening event. Using hospital records to identify individuals with lifetime experience of PTSD has proven challenging. Adjustment disorder (a related diagnosis) is often made alongside/instead of PTSD, and diagnoses may change between primary care (under a GP), and hospital care (inpatient/outpatient). PTSD requires a triggering traumatic event. However, the risk of developing PTSD following a traumatic event is affected by many factors, both environmental (for example, previous exposure to stressful environments), and genetic. Previous research by the Psychiatric Genomics Consortium (PGC) has shown that both environmental and genetic analyses of PTSD based on hospital records differ between PTSD being recorded once or multiple times. Here, we will use approaches developed by the PGC to define single and repeated diagnoses of PTSD from inpatient and outpatient hospital records data in Our Future Health, and consider adjustment disorder diagnoses as a broader indicator of PTSD. We will examine clinical and demographics differences between these definitions, and use genome-wide genotype data from Our Future Health to construct and compare polygenic risk scores for PTSD and related traits and conditions between diagnostic groups.

Post-traumatic stress disorder is common, but arguably under-diagnosed. 5% of people met criteria for PTSD during screening for the 2014 NHS Adult Psychiatric Morbidity Survey, but only 1 in 8 of those had been diagnosed with PTSD by a doctor. Some people may see their PTSD symptoms lessen without medical help, but for many, experiencing PTSD leads to long-term difficulties and poorer health, especially without treatment. A better understanding of diagnosed and undiagnosed PTSD would help inform public health screening and interventions. Not all treatments for mental illness work for all people, so new treatments are needed. Understanding the biology of mental illness can help with this, but requires clear definitions. Two decades of research have shown that many genetic changes that affect one aspect of mental ill health (like depression) also affect others (like PTSD). However, most people with PTSD also have depression. We might see the same genetic changes in PTSD and depression due to shared biology, or because we are mostly examining people who experience both disorders. Understanding this would help determine whether efforts to develop new treatments should focus on the specific biology of PTSD or on shared biology with other illnesses.

Public Health Research

27/11/2024

24/11/2024

TRE