Huan Song Associated Department of Medical Epidemiology and Biostatistics Karolinska Institutet

Stress Disorders Linked to Increase Risk of Autoimmune Disease Interview with:

Huan Song Associated Department of Medical Epidemiology and Biostatistics Karolinska Institutet

Huan Song

Huan Song
Department of Medical Epidemiology and Biostatistics
Karolinska Institutet What is the background for this study?

Response: Earlier findings from our group (e.g. Fang et al., NEJM 2012; Arnberg et al., Lancet Psychiatry 2015; Lu et al., JAMA Oncol 2016; Shen et al., BMJ 2016; Zhu et al., Ann Oncol 2017) have identified pathways through which stressful events contribute to deterioration in human health. With strong animal models and human data supporting a role of stress in immune dysregulation, the hypothesis linking mental distress with autoimmune is indeed plausible. However, the evidence is as yet limited to clinical observations and a few larger observational studies on US veterans, most of them on men only, and some of which have cross-sectional designs and various other methodological shortcomings. What are the main findings?

Response: In the current study, based on the nationwide population- and sibling-based comparisons with careful control of confounders, comorbidities, and surveillance bias, we demonstrated individuals who developed stress-related disorders after traumatic or other stressful events were at elevated risk of developing autoimmune diseases. Additionally, our findings include an intriguing observation suggesting that persistent use of selective serotonin reuptake inhibitors medications after diagnosis of posttraumatic stress disorder may reduce the risk of autoimmune disease. What should readers take away from your report? 

Response: Stress-related disorders brought on by traumatic- or other stressful life events were associated with increased risk of developing an autoimmune disease. What recommendations do you have for future research as a result of this work?

Response: We need more studies to inform the potential underlying mechanism behind the association of stress-related disorders and subsequent autoimmune diseases, for example exploring potential genetic- and early environmental contributors and the effect of alternations in health-related behavior.

Furthermore, our finding of a reduced relative risk of autoimmune disease among PTSD patients with persistent use of SSRIs calls for further studies, both with observational- and randomized-controlled designs.  

No disclosures


Song H, Fang F, Tomasson G, et al. Association of Stress-Related Disorders With Subsequent Autoimmune Disease. JAMA. 2018;319(23):2388–2400. doi:10.1001/jama.2018.7028

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Last Updated on June 21, 2018 by Marie Benz MD FAAD