{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T05:11:30Z","timestamp":1788930690820,"version":"build-2803163510"},"reference-count":46,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2015,11,4]]},"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Post-traumatic stress disorder (PTSD) is a well-documented risk factor for cardiovascular disease (CVD). However, it is unknown whether another common stress disorder\u2014adjustment disorder\u2014is also associated with an increased risk of CVD and whether gender modifies these associations. The aim of this study was to examine the overall and gender-stratified associations between PTSD and adjustment disorder and 4 CVD events.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Prospective cohort study utilising Danish national registry data.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>The general population of Denmark.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>PTSD (n=4724) and adjustment disorder (n=64\u2005855) cohorts compared with the general population of Denmark from 1995 to 2011.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Primary outcome measures<\/jats:title>\n                  <jats:p>CVD events including myocardial infarction (MI), stroke, ischaemic stroke and venous thromboembolism (VTE). Standardised incidence rates and 95% CIs were calculated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Associations were found between PTSD and all 4 CVD events ranging from 1.5 (95% CI 1.1 to 1.9) for MI to 2.1 (95% CI 1.7 to 2.7) for VTE. Associations that were similar in magnitude were also found for adjustment disorder and all 4 CVD events: 1.5 (95% CI 1.4 to 1.6) for MI to 1.9 (95% CI 1.8 to 2.0) for VTE. No gender differences were noted.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>By expanding beyond PTSD and examining a second stress disorder\u2014adjustment disorder\u2014this study provides evidence that stress-related psychopathology is associated with CVD events. Further, limited evidence of gender differences in associations for either of the stress disorders and CVD was found.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2015-009334","type":"journal-article","created":{"date-parts":[[2015,12,14]],"date-time":"2015-12-14T22:44:14Z","timestamp":1450133054000},"page":"e009334","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":70,"title":["Associations between stress disorders and cardiovascular disease events in the Danish population"],"prefix":"10.1136","volume":"5","author":[{"given":"Jaimie L","family":"Gradus","sequence":"first","affiliation":[{"name":"National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA"},{"name":"Departments of Psychiatry and Epidemiology, Boston University, Boston, Massachusetts, USA"},{"name":"Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D\u00f3ra K\u00f6rmendin\u00e9","family":"Farkas","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Svensson","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Ehrenstein","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy L","family":"Lash","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark"},{"name":"Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnold","family":"Milstein","sequence":"additional","affiliation":[{"name":"Clinical Excellence Research Center, Stanford University, Stanford, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Adler","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of California, San Fransisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik Toft","family":"S\u00f8rensen","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2015,12,14]]},"reference":[{"key":"2025101813163862000_5.12.e009334.1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.64.1.109"},{"key":"2025101813163862000_5.12.e009334.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2010.02.033"},{"key":"2025101813163862000_5.12.e009334.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.04.085"},{"key":"2025101813163862000_5.12.e009334.4","unstructured":"Beristianos MH , Yaffe K , Cohen B , et al . PTSD and risk of incident cardiovascular disease in aging veterans. Am J Geriatr Psychiatry 2014. in press."},{"key":"2025101813163862000_5.12.e009334.5","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2014.302342"},{"key":"2025101813163862000_5.12.e009334.6","doi-asserted-by":"publisher","DOI":"10.1097\/PSY.0b013e3181bc76b5"},{"key":"2025101813163862000_5.12.e009334.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2011.10.014"},{"key":"2025101813163862000_5.12.e009334.8","unstructured":"Janca A , Ustun TB , van Drimmelen J , et al . ICD-10 symptom checklist for mental disorders, version 1.1. Geneva: Division of Mental Health, World Health Organization, 1994."},{"key":"2025101813163862000_5.12.e009334.9","doi-asserted-by":"publisher","DOI":"10.1002\/jts.21926"},{"key":"2025101813163862000_5.12.e009334.10","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1002\/j.2051-5545.2011.tb00003.x","article-title":"Adjustment disorders: the state of the art","volume":"10","author":"Casey","year":"2011","journal-title":"World Psychiatry"},{"key":"2025101813163862000_5.12.e009334.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2013.07.031"},{"key":"2025101813163862000_5.12.e009334.12","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e356"},{"key":"2025101813163862000_5.12.e009334.13","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.968792"},{"key":"2025101813163862000_5.12.e009334.14","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.164.4.394"},{"key":"2025101813163862000_5.12.e009334.15","doi-asserted-by":"publisher","DOI":"10.1037\/0278-6133.28.1.125"},{"key":"2025101813163862000_5.12.e009334.16","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.014492"},{"key":"2025101813163862000_5.12.e009334.17","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-014-9930-3"},{"key":"2025101813163862000_5.12.e009334.18","first-page":"82","article-title":"The Danish Psychiatric Central Register","volume":"44","author":"Munk-Jorgensen","year":"1997","journal-title":"Dan Med Bull"},{"key":"2025101813163862000_5.12.e009334.19","doi-asserted-by":"publisher","DOI":"10.1177\/1403494810395825"},{"key":"2025101813163862000_5.12.e009334.20","doi-asserted-by":"crossref","first-page":"235","DOI":"10.2147\/CLEP.S80514","article-title":"Validity of reaction to severe stress and adjustment disorders diagnoses in the Danish Psychiatric Central Research Registry","volume":"7","author":"Svensson","year":"2015","journal-title":"Clin Epidemiol"},{"key":"2025101813163862000_5.12.e009334.21","doi-asserted-by":"publisher","DOI":"10.1177\/1403494811401482"},{"key":"2025101813163862000_5.12.e009334.22","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"2025101813163862000_5.12.e009334.23","unstructured":"Rothman KJ , Boice JD . Epidemiologic analyses with a programmable calculator. Washington DC: Government Printing Office, 1979."},{"key":"2025101813163862000_5.12.e009334.24","doi-asserted-by":"publisher","DOI":"10.1001\/jama.284.20.2606"},{"key":"2025101813163862000_5.12.e009334.25","doi-asserted-by":"publisher","DOI":"10.1016\/S0033-0620(03)00079-3"},{"key":"2025101813163862000_5.12.e009334.26","unstructured":"Greenland S , Lash TL . Bias analysis. In: Rothman KJ , Greenland S , Lash TL, eds . Modern epidemiology, 3rd edn. Philadelphia, PA: Lippincott, Williams & Wilkins, 2008:345\u201380."},{"key":"2025101813163862000_5.12.e009334.27","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2013.03.004"},{"key":"2025101813163862000_5.12.e009334.28","doi-asserted-by":"publisher","DOI":"10.2174\/1874192401105010164"},{"key":"2025101813163862000_5.12.e009334.29","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1016\/j.amjcard.2011.07.003","article-title":"Post-traumatic stress disorder and cardiovascular disease link: time to identify specific pathways and interventions","volume":"108","author":"Boscarino","year":"2011","journal-title":"Am J Cardiol"},{"key":"2025101813163862000_5.12.e009334.30","doi-asserted-by":"publisher","DOI":"10.1097\/CRD.0b013e318265343b"},{"key":"2025101813163862000_5.12.e009334.31","first-page":"642","article-title":"Cardiovascular manifestations of posttraumatic stress disorder","volume":"99","author":"Bedi","year":"2007","journal-title":"J Natl Med Assoc"},{"key":"2025101813163862000_5.12.e009334.32","doi-asserted-by":"publisher","DOI":"10.1007\/s12160-010-9165-9"},{"key":"2025101813163862000_5.12.e009334.33","doi-asserted-by":"publisher","DOI":"10.1002\/j.2051-5545.2010.tb00254.x"},{"key":"2025101813163862000_5.12.e009334.34","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1016\/S0140-6736(14)61468-9","article-title":"Hypertension","volume":"386","author":"Poulter","year":"2015","journal-title":"Lancet"},{"key":"2025101813163862000_5.12.e009334.35","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2012.45"},{"key":"2025101813163862000_5.12.e009334.36","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000079818.08343.8C"},{"key":"2025101813163862000_5.12.e009334.37","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)62296-9"},{"key":"2025101813163862000_5.12.e009334.38","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.968776"},{"key":"2025101813163862000_5.12.e009334.39","first-page":"580","article-title":"The relationship of depression to cardiovascular disease","volume":"55","author":"Musselman","year":"1998","journal-title":"JAMA Psychiatry"},{"key":"2025101813163862000_5.12.e009334.40","first-page":"235","article-title":"Validity of reaction to severe stress and adjustment disorders diagnoses in the Danish Psychiatric Central Research Registry","volume":"7","author":"Svensson","year":"2014","journal-title":"Clin Epidemiol"},{"key":"2025101813163862000_5.12.e009334.41","doi-asserted-by":"crossref","first-page":"2013","DOI":"10.1212\/WNL.0000000000001024","article-title":"Preadmission use of nonaspirin nonsteroidal anti-inflammatory drugs and 30-day stroke mortality","volume":"83","author":"Schmidt","year":"2014","journal-title":"Neurology"},{"key":"2025101813163862000_5.12.e009334.42","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.025627"},{"key":"2025101813163862000_5.12.e009334.43","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(02)00391-8"},{"key":"2025101813163862000_5.12.e009334.44","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2009.03.018"},{"key":"2025101813163862000_5.12.e009334.45","unstructured":"Statistics Denmark. Visit to a doctor etc. 2010. http:\/\/www.dst.dk\/homeuk\/Statistics\/focus_on\/focus_on_show.aspx?sci=1316"},{"key":"2025101813163862000_5.12.e009334.46","unstructured":"Greenland S , Rothman KJ , Lash TL . Measures of effect and measures of association. In: Rothman KJ , Greenland S , Lash TL, eds . Modern epidemiology, 3rd edn. Philadelphia, PA: Lippincott, Williams & Wilkins, 2008:51\u201370."}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2015-009334","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T20:16:44Z","timestamp":1760818604000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2015-009334"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,12]]},"references-count":46,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2015,12,14]]},"published-print":{"date-parts":[[2015,12]]}},"alternative-id":["10.1136\/bmjopen-2015-009334"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2015-009334","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,12]]}}}