Trauma survivors are significantly more likely to have a number of serious illnesses and to die prematurely than are their nonabused counterparts. This includes increased risk for cardiovascular disease, diabetes, and metabolic syndrome, the precursor to type 2 disease. This entry describes three common sequelae of trauma—depression, hostility, and sleep disturbances—and how these sequelae increase the risk of heart disease, metabolic syndrome, and diabetes.

Depression

Depression is a common mood disorder among trauma survivors and is a risk factor for disease. Specifically, depression increases inflammation, which includes high levels of proinflammatory cyto-kines and acute-phase proteins, such as C-reactive protein (CRP). Increased inflammation increases the risk factor for cardiovascular disease.

Depression in early adulthood may actually promote vascular injury, and inflammation may increase further early-stage cardiovascular disease by encouraging ...

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