{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T10:49:34Z","timestamp":1791456574288,"version":"4.3.4"},"reference-count":0,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"abstract":"\n Objective<\/jats:title>\n We examined associations of post\u2010traumatic stress disorder (PTSD) and other mental health disorders (OMH) with rheumatoid arthritis (RA), accounting for effects of smoking.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We conducted a matched case\u2010control study, identifying incident RA cases and controls using national Veteran Health Administration data (2006\u20102019). PTSD\/OMH exposures prior to RA diagnosis were identified using administrative\/diagnostic codes. Conditional logistic regression examined associations of RA (vs. no\u2010RA) with PTSD (\u00b1OMH) and OMH. Relative Excess Risk of Interaction was calculated between OMH\/PTSD and smoking using standard multivariable logistic regression with standard errors clustered within match groups stratified by ever\/never smoking. Analyses were repeated excluding individuals without a visit in the previous year.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 357,361 Veterans (mean age 53 years, 87% male, 70% ever smoked) were studied. Both PTSD (19% vs. 13%) and OMH (31% vs. 26%) were more frequent in RA than controls. Multivariable analyses demonstrated associations of PTSD and OMH with RA with evidence of PTSD\/OMH\u2010smoking interactions; associations were stronger in never (aORs 1.54\/1.40, respectively) vs. ever smokers (aORs 1.20\/1.08). Excluding individuals without a healthcare visit, PTSD and OMH remained associated with seronegative RA in ever (aOR 1.17; 95% CI 1.09\u20101.26 and aOR 1.14; 95% CI 1.06\u20101.21) and never smokers (aOR 1.37; 95% CI 1.16\u20101.62 and aOR 1.27; 95% CI 1.10\u20101.47); similar associations of PTSD\/OMH with seropositive RA were not observed.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n This study demonstrates that the relationships of PTSD (and OMH) with RA differ by smoking status. The strongest associations between PTSD\/OMH and incident RA were among never smokers and in seronegative disease.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/acr.80184","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T09:52:53Z","timestamp":1791453173000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect Modification of Cigarette Smoking on the Relationship between Post\u2010traumatic Stress Disorder, Other Mental Health Conditions and Rheumatoid Arthritis Risk: A Large Case\u2010Control Study in U.S. Veterans"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-2342-306X","authenticated-orcid":false,"given":"Kelsey","family":"Coziahr","sequence":"first","affiliation":[{"name":"VA Nebraska\u2010Western Iowa Health Care System & University of Nebraska Medical Center Omaha NE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harlan","family":"Sayles","sequence":"additional","affiliation":[{"name":"VA Nebraska\u2010Western Iowa Health Care System & University of Nebraska Medical Center Omaha NE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0335-4157","authenticated-orcid":false,"given":"Tate M.","family":"Johnson","sequence":"additional","affiliation":[{"name":"VA Nebraska\u2010Western Iowa Health Care System & University of Nebraska Medical Center Omaha NE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0799-7563","authenticated-orcid":false,"given":"Joshua F.","family":"Baker","sequence":"additional","affiliation":[{"name":"Corporal Michael J. Crescenz VA Medical Center & University of Pennsylvania Philadelphia PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Punyasha","family":"Roul","sequence":"additional","affiliation":[{"name":"VA Nebraska\u2010Western Iowa Health Care System & University of Nebraska Medical Center Omaha NE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6640-9173","authenticated-orcid":false,"given":"Grant W.","family":"Cannon","sequence":"additional","affiliation":[{"name":"Salt Lake City VA Health Care System & University of Utah Salt Lake City UT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary A.","family":"Kunkel","sequence":"additional","affiliation":[{"name":"Salt Lake City VA Health Care System & University of Utah Salt Lake City UT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine D.","family":"Wysham","sequence":"additional","affiliation":[{"name":"VA Puget Sound Health Care System & University of Washington Seattle WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gail S.","family":"Kerr","sequence":"additional","affiliation":[{"name":"Washington, DC VA, Georgetown University Howard University Washington DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5245-3998","authenticated-orcid":false,"given":"Amir A.","family":"Razmjou","sequence":"additional","affiliation":[{"name":"Greater Los Angeles VA Health Care System & University of California Los Angeles Los Angeles CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac","family":"Smith","sequence":"additional","affiliation":[{"name":"Durham VA & Duke University Durham NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L.","family":"Barton","sequence":"additional","affiliation":[{"name":"VA Portland Health Care System & Oregon Health & Science University Portland OR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9246-6200","authenticated-orcid":false,"given":"Maria I.","family":"Danila","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham & Birmingham VAMC Birmingham AL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan S.","family":"Richards","sequence":"additional","affiliation":[{"name":"Pittsburgh VA & University of Pittsburgh Pittsburgh PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9649-3588","authenticated-orcid":false,"given":"Bryant R.","family":"England","sequence":"additional","affiliation":[{"name":"VA Nebraska\u2010Western Iowa Health Care System & University of Nebraska Medical Center Omaha NE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ted R.","family":"Mikuls","sequence":"additional","affiliation":[{"name":"VA Nebraska\u2010Western Iowa Health Care System & University of Nebraska Medical Center Omaha NE"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,8]]},"container-title":["Arthritis Care & Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr.80184","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr.80184","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T09:52:54Z","timestamp":1791453174000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/acr.80184"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,8]]},"references-count":0,"alternative-id":["10.1002\/acr.80184"],"URL":"https:\/\/doi.org\/10.1002\/acr.80184","archive":["Portico"],"relation":{},"ISSN":["2151-464X","2151-4658"],"issn-type":[{"value":"2151-464X","type":"print"},{"value":"2151-4658","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,8]]},"assertion":[{"value":"2026-03-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"acr.80184"}}