Scholarlink

Background <p>Only a subset of trauma-exposed individuals develop post-traumatic stress disorder (PTSD), suggesting pre-existing characteristics may be associated with differential risk. The predictive value of pre-trauma physical symptoms, such as headache, remains unclear in large population-based cohorts.</p> Methods <p>We conducted a retrospective cohort study of 1,126,651 Israeli young adults evaluated for mandatory military service (1998–2019). Headache history was documented at recruitment. Combat-related PTSD diagnoses were identified through military and Ministry of Defense psychiatric registries. Logistic regression models assessed the association between pre-enlistment headache and subsequent PTSD, adjusting for sex, cognitive ability, socioeconomic status, and combat assignment. Predictive performance was evaluated using a hold-out validation split.</p> Results <p>Headache was reported by 4.37% of participants. Pre-enlistment headache was associated with increased odds of subsequent PTSD (adjusted OR = 1.32, 95% CI 1.17–1.47, <i>p</i> &lt; 0.001). A significant sex interaction was observed, with a stronger association among women (OR = 1.53, 95% CI 1.31–1.74, <i>p</i> &lt; 0.001) than men (OR = 1.28, 95% CI 1.10–1.50, <i>p</i> = 0.011). In univariate analysis, headache status demonstrated limited discrimination (AUC = 0.55, 95% CI 0.51–0.59). Among individuals with pre-enlistment headache, combat service was associated with higher PTSD risk (OR = 1.28, 95% CI 1.00–1.63, <i>p</i> = 0.048).</p> Conclusions <p>Pre-enlistment headache appears to be an independent predictive clinical marker of increased PTSD risk following combat-related trauma. While headache history shows statistically significant but modest discrimination at the population level, its clinical utility as a standalone screener is limited. These findings suggest that incorporating neurological history into multifactorial models may contribute to improved identification of high-risk individuals.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Headache as a predictive clinical marker for combat-related PTSD risk

  • 期刊论文

  • 发表日期：

    2026年6月1日

查看全文
  • Melanie Shanie Roitman,
  • Erez Magiel,
  • Gabriel Ricardo Lichtenstein,
  • Yigal Chechik,
  • Nadav Calderon,
  • Nicola Maggio,
  • Roni Sharon,
  • Shlomi Abuhasira

摘要

Background

Only a subset of trauma-exposed individuals develop post-traumatic stress disorder (PTSD), suggesting pre-existing characteristics may be associated with differential risk. The predictive value of pre-trauma physical symptoms, such as headache, remains unclear in large population-based cohorts.

Methods

We conducted a retrospective cohort study of 1,126,651 Israeli young adults evaluated for mandatory military service (1998–2019). Headache history was documented at recruitment. Combat-related PTSD diagnoses were identified through military and Ministry of Defense psychiatric registries. Logistic regression models assessed the association between pre-enlistment headache and subsequent PTSD, adjusting for sex, cognitive ability, socioeconomic status, and combat assignment. Predictive performance was evaluated using a hold-out validation split.

Results

Headache was reported by 4.37% of participants. Pre-enlistment headache was associated with increased odds of subsequent PTSD (adjusted OR = 1.32, 95% CI 1.17–1.47, p < 0.001). A significant sex interaction was observed, with a stronger association among women (OR = 1.53, 95% CI 1.31–1.74, p < 0.001) than men (OR = 1.28, 95% CI 1.10–1.50, p = 0.011). In univariate analysis, headache status demonstrated limited discrimination (AUC = 0.55, 95% CI 0.51–0.59). Among individuals with pre-enlistment headache, combat service was associated with higher PTSD risk (OR = 1.28, 95% CI 1.00–1.63, p = 0.048).

Conclusions

Pre-enlistment headache appears to be an independent predictive clinical marker of increased PTSD risk following combat-related trauma. While headache history shows statistically significant but modest discrimination at the population level, its clinical utility as a standalone screener is limited. These findings suggest that incorporating neurological history into multifactorial models may contribute to improved identification of high-risk individuals.