Erfðir heilsufars í kjölfar áfalla - verkefni lokið

Fréttatilkynning verkefnisstjóra

2.6.2022

Flest verðum við fyrir áföllum á lífsleiðinni en slík lífsreynsla getur haft neikvæð áhrif á heilsu okkar. Markmið þessarar öndvegisáætlunar var að varpa ljósi á nýjar heilsufarsafleiðingar áfalla og þátt erfða í mismunandi þróun heilsufars eftir áföll.

Rannsakendur notuðust við einstaka lýðgrundaða gagnagrunna á Íslandi og Svíþjóð í rannsóknum sínum en niðurstöður þeirra hingað til hafa birst í nokkrum af fremstu vísindatímaritum heims. Niðurstöðurnar benda meðal annars til þess að mæður sem missa barn eru í aukinni áhættu á ótímabæru andláti (Valdimarsdóttir, eLife 2019), og að einstaklingar sem þróa með sér geðröskun í kjölfar áfalls séu til lengri tíma í aukinni áhættu á sjálfsónæmissjúkdómum (Song et al., JAMA 2018), hjarta- og æðasjúkdómum (Song et al., BMJ 2019), lífshættulegum sýkingum (Song et al., BMJ 2019) og taugahrörnunarsjúkdómum (Song et al., JAMA Neurol 2020). Þá sýna rannsakendur einnig fram á að tengsl áfalla og heilsufarsafleiðinga (t.d. uppkomu geðraskana eftir greiningu krabbameins) eru einungis að litlu leyti ákvörðuð af erfðum. Annað mikilvægt markmið öndvegisáætlunarinnar var að varpa ljósi á erfðir áfallastreituröskunar. Í þessum tilgangi var farið út í umfangsmiklar gagnasafnanir meðal íslenskra kvenna, Áfallasögu kvenna (N=31.795), og frá sænskum eftirlifendum Tsunamihamfaranna í suðaustur Asíu, 2004 (N=5000). Gagnagreining er í fullum gangi en frumniðurstöður benda til að þessi öndvegisáætlun muni auka verulega skilning okkar á þeim lífræðilegu ferlum sem búa að baki heilsubresti í kjölfar áfalla.

English:

Most humans are at some point in their lives exposed to significant life stressors or trauma with potential negative implications for their health. In this program, the researchers aimed to determine new health risks involved for individuals exposed to significant life stressors or trauma and the genetic determinants of varying trajectories of morbidities after trauma. Leveraging the unique Icelandic and Swedish nationwide register resources, the major findings of these studies, published in some of the leading international scientific journals), suggest that mothers exposed to child loss experience an increased risk of premature death (Valdimarsdóttir et al., eLife 2019), and that individuals who display severe psychiatric reactions to trauma experience increased subsequent risks of autoimmune disease (Song et al., JAMA 2018), cardiovascular disease (Song et al., BMJ, 2020), life-threatening infections (Song et al., BMJ 2019), and neurodegenerative disease (Song et al., JAMA Neurol 2020). Moreover, the findings suggest that the strong associations between trauma and adverse health outcomes (e.g. cancer diagnosis and psychiatric disorders) is only to a limited extent explained by genetic factors. To advance our current understanding of the genetic contribution to posttraumatic stress disorder, the researchers further undertook two large scale data collections, the SAGA cohort of 31.795 Icelandic women and Swedish tsunami survivors (N=5000). The analytic work is still ongoing while the preliminary findings lend promise that the program will significantly advance our understanding of the biologic sequel of health deterioration after trauma.  

Information on how the results will be applied

The results from this project have considerable clinical and public health implications, as they identify vulnerable groups exposed to trauma and an array of novel health consequences suffered by these exposed individuals. Thus, the findings of this program will also be used to monitor and potentially prevent adverse symptoms and diseases in these traumatised groups. Finally, this program has significant implications for future research as it identifies new areas that need more study (e.g. underlying biological mechanisms between trauma and autoimmune disease) as well contributes two new established trauma cohorts which can be leveraged for further scientific studies for years to come.

A list of the project’s outputs

SAGA cohort manuscripts in published or in publication process:

Valdimarsdóttir UA, Thordardóttir EB, Tómasson G, Rúnarsdóttir H, Jónsdóttir HL, Torfadóttir JE, Jakobsdóttir J, Aspelund T, Halldórsdóttir Th, Björnsson AS and Hauksdóttir A. The SAGA (Stress-And-Gene Anlysis) Cohort: Cohort Profile. In publication process.

Lynch R, Aspelund T, Kormáksson M, Flores-Torres MH, Hauksdóttir A, Lajous M, Kirschbaum C, Valdimarsdóttir U. Lifetime exposure to violence and other life stressors and hair cortisol concentration. Stress. 2022 Jan 10:1-9. doi: 10.1080/10253890.2021. 2011204.

∙ Jónsdóttir HL, Hauksdóttir A, Thordardottir E, Larsson H, Jakobsdóttir J, Valdimarsdóttir U. The role of ADHD in PTSD symptomology after trauma. In publication process.

∙ Yang Q, Hauksdóttir A, Thordardottir EB, Jakobsdóttir J, Aspelund T, Valdimarsdóttir U, Lu D. Adverse childhood experiences and premenstrual syndrome in Icelandic women. Published in BMC Medicine.

∙ Ásgeirsdóttir TL, Gylfasson G, Hauksdóttir A, Þórðardóttir EB, Valdimarsdóttir UA. Monetizing utility reductions associated with bullying. Under review at Applied Economics

∙ Thordardottir EB, Song H, Shen Q, Aspelund T, Guðmunsdóttir B, Björnsson A, Holmes E, Tómasson G, Sigurðsson E, Hultman CM, Fang F, Hauksdótir A, Valdimarsdóttir U. Prevalence and propsensity of varying trauma types in posttraumatic stress symptomology in Icelandic women. In publication process.

Jónsdóttir SD, Hauksdóttir A, Aspelund T, Jakobsdóttir J, Runarsdottir H, Gudmundsdottir B, Tomasson G, Valdimarsdottir UA, Halldorsdottir T, Thordardottir EB. Risk factors of workplace sexual harassment and violence among women: A population-based study. Submiteed to Lancet Public Health.

∙ Danielsdottir H, Thordardóttir EB, Halldórsdóttir Th, Jakobsdóttir J, Hauksdóttir A, Magnusson P, Fall K, Fang F, Aspelund T, Valdimarsdóttir U. Adverse childhood experiences and resilience among adult women: a population-based study. Published in eLife.

∙ Unnarsdottir AB, Hauksdóttir A, Aspelund T, Gunnarsdóttir V, Tómasson G, Jakobsdóttir J, Valdimarsdóttir UA, Thordardottir EB. Sleep Disturbances among Women in a Subarctic region: A Nationwide Study. Invited resubmission to the journal Sleep.

The Tsunami Cohort:

 ∙ Gudmundsdottir R, Hultman CM, Valdimarsdóttir U. Evacuation of Swedish survivors after the 2004 Southeast Asian tsunami: The survivors' perspective and symptoms of post-traumatic stress. Scand J Public Health. 2019;47(2):260-268. doi: 10.1177/1403494818771418.

∙ Thordardottir EB, Song H, Arnberg FK, Hauksdottir A, Fang F, Butwicka A, Lichtenstein P, Hultman CM, Valdimarsdottir U. Rates of Clinically Confirmed Stress-related Psychiatric Disorders Among Swedish Tsunami Survivors: 9-year Follow-up. Epidemiology. 2022 Jan 1;33(1):e5-e6. doi: 10.1097/EDE.0000000000001436. PMID: 34799476.

∙ Thordardottir EB, Valdimarsdóttir UA, Hultman C, Fang F, Hauksdóttir A. Hypnotic medication use among Swedish tsunami survivors. In publication process.

 ∙ Publications

Song H, Fang F, Tomasson G, Arnberg FK, Mataix-Cols D, Fernández de la Cruz L, Almqvist C, Fall K, Valdimarsdóttir UA. Association of Stress-Related Disorders With Subsequent Autoimmune Disease. JAMA. 2018 Jun 19;319(23):2388-2400. doi: 10.1001/jama.2018.7028.

Song H, Fang F, Arnberg FK, Mataix-Cols D, Fernández de la Cruz L, Almqvist C, Fall K, Lichtenstein P, Thorgeirsson G, Valdimarsdóttir UA. Stress related disorders and risk of cardiovascular disease: population based, sibling controlled cohort study. BMJ. 2019 Apr 10;365:l1255. doi: 10.1136/bmj.l1255.

Song H, Fall K, Fang F, Erlendsdóttir H, Lu D, Mataix-Cols D, Fernández de la Cruz L, D'Onofrio BM, Lichtenstein P, Gottfreðsson M, Almqvist C, Valdimarsdóttir UA. Stress related disorders and subsequent risk of life threatening infections: population based sibling controlled cohort study. BMJ. 2019 Oct 23;367:l5784. doi: 10.1136/bmj.l5784.

Song H, Sieurin J, Wirdefeldt K, Pedersen NL, Almqvist C, Larsson H, Valdimarsdóttir UA, Fang F. Association of Stress-Related Disorders With Subsequent Neurodegenerative Diseases. JAMA Neurol. 2020;. doi: 10.1001/jamaneurol.2020.0117.

Valdimarsdóttir UA, Lu D, Lund SH, Fall K, Fang F, Kristjánsson Þ, Guðbjartsson D, Helgason A, Stefánsson K. The mother's risk of premature death after child loss across two centuries. Elife. 2019 Nov 12;8. pii: e43476. doi: 10.7554/eLife.43476.

Valdimarsdottir UA. [Stress-related disorders - a major challenge of 21st century medical sciences]. Laeknabladid. 2019;105(12):543. doi: 10.17992/lbl.2019.12.258.

Su G, Song H, Lanka V, Liu X, Fang F, Valdimarsdóttir UA, Carrero JJ. Stress Related Disorders and the Risk of Kidney Disease. Kidney Int Rep. 2021;6(3):706-715.

Song H, Fang F, Larsson H, Pedersen NL, Magnusson PK, Almqvist C, Valdimarsdóttir UA. Loss of a co-twin at birth and subsequent risk of psychiatric disorders. Elife. 2021 Jan 28;10:e63514. doi: 10.7554/eLife.63514.

Song H, Larsson H, Fang F, Almqvist C, Pedersen NL, Magnusson PK, Valdimarsdóttir UA. Risk of psychiatric disorders among the surviving twins after a co-twin loss. Elife. 2020 Jul 14;9:e56860. doi: 10.7554/eLife.56860.

Lu D*, Song*, Lu Y, Fall K, Chen X, Fang F, Landén M, Hultman CM, Czene K, Sullivan P, Tamimi RM#, Valdimarsdóttir UA#. A shared genetic contribution to breast cancer and schizophrenia. Nat Commun. 2020;11(1):4637.

Vilaplana-Pérez A, Sidorchuk A, Pérez-Vigil A, Brander G, Isoumura K, Hesselmark E, Sevilla-Cermeño L, Valdimarsdóttir UA, Song H, Jangmo A, Kuja-Halkola R, D'Onofrio BM, Larsson H, Garcia-Soriano G, Mataix-Cols D, Fernández de la Cruz L. Assessment of Posttraumatic Stress Disorder and Educational Achievement in Sweden. JAMA Netw Open. 2020;3(12):e2028477.

Li Y, Sjölander A, Song H, Cnattingius S, Fang F, Yang Q, Fernández de la Cruz L, Mataix-Cols D, Brander G, Li J, Zhang W, Fall K, D'Onofrio BM, Almqvist C, Lichtenstein P, Valdimarsdóttir UA, Lu D. Associations of parental and perinatal factors with subsequent risk of stress-related disorders: a nationwide cohort study with sibling comparison. Mol Psychiatry 2022 Jan 1. doi: 10.1038/s41380-021-01406-5.

Gudmundsdottir R, Hultman CM, Valdimarsdóttir U. Evacuation of Swedish survivors after the 2004 Southeast Asian tsunami: The survivors' perspective and symptoms of post-traumatic stress. Scand J Public Health. 2019;47(2):260-268. doi: 10.1177/1403494818771418.

Thordardottir EB, Song H, Arnberg FK, Hauksdottir A, Fang F, Butwicka A, Lichtenstein P, Hultman CM, Valdimarsdottir U. Rates of Clinically Confirmed Stress-related Psychiatric Disorders Among Swedish Tsunami Survivors: 9-year Follow-up. Epidemiology. 2022 Jan 1;33(1):e5-e6. doi: 10.1097/EDE.0000000000001436. PMID: 34799476.

Lynch R, Aspelund T, Kormáksson M, Flores-Torres MH, Hauksdóttir A, Lajous M, Kirschbaum C, Valdimarsdóttir U. Lifetime exposure to violence and other life stressors and hair cortisol concentration. Stress. 2022 Jan 10:1-9. doi: 10.1080/10253890.2021. 2011204.

Danielsdottir H, Thordardóttir EB, Halldórsdóttir Th, Jakobsdóttir J, Hauksdóttir A, Magnusson P, Fall K, Fang F, Aspelund T, Valdimarsdóttir U. Adverse childhood experiences and resilience among adult women: a population-based study. Elife. 2022 Feb 1;11:e71770. doi: 10.7554/eLife.71770.

Yang Q, Hauksdóttir A, Thordardottir EB, Jakobsdóttir J, Aspelund T, Valdimarsdóttir U, Lu D. Adverse childhood experiences and premenstrual syndrome in Icelandic women. BMC Med. 2022 Feb 21;20(1):60. doi: 10.1186/s12916-022-02275-7.

Yang H, Zeng Y, Chen W, Sun Y, Hu Y, Ying Z, Wang J, Qu Y, Fang F, Valdimarsdóttir UA, Song H. The role of genetic predisposition in cardiovascular risk after cancer diagnosis: a matched cohort study of the UK Biobank. Submitted.

Ge F, Chen W, Wang Y, Yang H, Han X, Hou C, Song H, Valdimarsdóttir UA. The role of genetic susceptibility in common psychiatric disorders risk after a cancer diagnosis: a matched cohort study based on the UK Biobank. Manuscript in publication process.

Heiti verkefnis: Erfðir heilsufars í kjölfar áfalla / The genetics of morbidity and survival in response to significant life stressor
Verkefnisstjóri: Unnur Anna Valdimarsdóttir, Háskóla Íslands

Tegund styrks: Öndvegisstyrkur
Styrktímabil: 2016-2018
Fjárhæð styrks: 143,143 millj. kr. alls
Tilvísunarnúmer Rannís: 163362









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