Study Suggests PTSD is Associated with Cognitive Impairment
BACKGROUND:
Epidemiological studies estimate that exposure to a traumatic event affects 50% to 70% of the general population. Among victims of traumatic events, PTSD is a common but serious mental health consequence. PTSD can be a chronic condition that may affect memory and other cognitive domains. Neuroanatomical changes and cognitive impairments also are reported to be present in subjects with a history of physical or psychological trauma. This systematic review analyzed data from 21 articles published between 1968 and 2009 that examined memory and cognitive function in subjects with chronic PTSD compared to subjects who had been exposed to trauma but did not have PTSD. Eight of the studies that were analyzed included Veterans.
FINDINGS:
- Chronic post-traumatic stress disorder is associated with cognitive impairment, particularly in Veterans, when compared to individuals with a history of trauma but no PTSD.
- The severity of PTSD is positively correlated with cognitive impairment.
- Strong evidence, especially in studies of Veterans, refugees, and war victims, suggests that individuals with PTSD have a poorer ability to sustain attention compared with individuals who have a history of exposure to trauma.
- Memory was the most commonly examined cognitive domain (18 out of 21 studies). After controlling for confounding factors, there was no consistent association between PTSD and impaired memory across these studies.
LIMITATIONS:
- The studies used for this analysis were heterogeneous, which did not allow investigators to combine results in a quantitative synthesis (e.g., meta-analysis).
- Studies did not completely adjust for confounding by other disorders that might impact cognition (e.g., depression and head trauma).
- Cognitive domains were not divided into their sub-types (e.g., memory was not divided into explicit, implicit, verbal, or non-verbal).
- Investigators included only studies that had a comparison group exposed to trauma. Had PTSD exposure been compared to non-trauma exposed subjects, greater differences may have been evident.
AUTHOR/FUNDING INFORMATION:
Drs. Qureshi, Long, and Kunik are part of HSR&D’s Houston Center for Quality of Care & Utilization Studies. Drs. Pyne, Kimbrell, and Hudson are part of HSR&D’s Center for Mental Healthcare and Outcomes Research in Little Rock, AR. Dr. Magruder is part of HSR&D’s Center for Disease Prevention and Health Interventions for Diverse Populations in Charleston, SC.
Qureshi S, Long M, Bradshaw M, Pyne J, Magruder K, Kimbrell T, Hudson T, Jawaid A, Schulz P, Kunik M. Does PTSD Impair Cognition Beyond the Effect of Trauma? Journal of Neuropsychiatry and Clinical Neurosciences 2011 Fall;23(1):16-28.
