Researchers Find Significant Association Between PTSD and Certain Diseases

Researchers found "that a PTSD diagnosis was associated significantly with a 56 percent increased risk of hypertensive disease, a 36 percent increased risk of circulatory disease, a 24 percent increased risk of digestive disease, an 81 percent increased risk of nervous system disease, and a 70 percent increased risk of “ill-defined signs and symptoms,” compared with veterans who did not have PTSD".


Full Article at: Early PTSD Treatment Could Avert Vets' Multiple Physical Illnesses


A strong link between PTSD and circulatory, musculoskeletal, digestive, and other diseases shows up soon after veterans return from fighting in Iraq or Afghanistan.

Veterans of the Iraq and Afghanistan wars diagnosed with posttraumatic stress disorder (PTSD) have higher-than-usual rates of several physical ailments, according to a study of 4,416 such veterans.

The diagnosis in primary care settings of physical disorders in these combat veterans came only three to seven months after they received a PTSD diagnosis.

“What is particularly striking about these findings is that diseases traditionally considered to develop across the lifespan (e.g., circulatory system and hypertensive conditions) appeared shortly after the end of military service,” wrote Judith Andersen, Ph.D., and colleagues from the Center for Integrated Healthcare at the Department of Veterans Affairs Medical Center in Syracuse, N.Y.

Veterans of recent conflicts may thus be subject to increases in “lifespan morbidity, mortality, and health care utilization in the coming years,” they pointed out.

“I'm not surprised by the findings,” commented Joseph Boscarino, Ph.D., M.P.H. “But I am surprised at how quickly these problems showed up. I thought it would take another five or 10 years.”

Boscarino is senior investigator at the Geisinger Center for Health Research in Danville, Pa, and an adjunct professor of psychiatry at Temple University. He has researched the effects of PTSD on physical illness among Vietnam War veterans, but was not involved in the present study.

Andersen and colleagues examined the VA medical records of service members who had served in “zones of imminent danger” from September 11, 2001, to December 31, 2007. They were screened for mental and physical conditions when they entered the VA system and annually thereafter.

The average age of the participants was 29; 85 percent were white. Roughly half (53 percent) had served in the active-duty components of their service, while 47 percent were National Guard or reserve veterans.

At entry, 277 (6 percent) of the 4,416 participants were diagnosed with PTSD. Over the six-year study, 1,031 (24.6 percent) of the veteran participants received a PTSD diagnosis. Patients were followed for an average of about 17 months.

The researchers adjusted initial results for covariates such as age, gender, marital status, depression, substance use disorders, and unit type.

They found that a PTSD diagnosis was associated significantly with a 56 percent increased risk of hypertensive disease, a 36 percent increased risk of circulatory disease, a 24 percent increased risk of digestive disease, an 81 percent increased risk of nervous system disease, and a 70 percent increased risk of “ill-defined signs and symptoms,” compared with veterans who did not have PTSD.

No increased risk of respiratory or endocrine, nutritional, or metabolic illnesses was observed, they noted.

PTSD is a “unique contributor to disease” even after controlling for depression, substance abuse, and other factors known to affect physical-illness onset, the authors said.




Abstract:
Association Between Posttraumatic Stress Disorder and Primary Care Provider-Diagnosed Disease Among Iraq and Afghanistan Veterans
Judith Andersen , PhD, Michael Wade , MS, Kyle Possemato , PhD, Paige Ouimette , PhD


Address correspondence and reprint requests to: Paige Ouimette, PhD, E-mail: paigec.ouimette{at}med.va.gov.


Abstract

Objective: To determine if a diagnosis of posttraumatic stress disorder (PTSD) was associated with primary care provider-diagnosed physical disease in the first 5 years post deployment. Methods: An examination of medical records of 4416 veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) was conducted. Participants were veterans who served between September 11, 2001 and December 31, 2007, without prior combat exposure, and who utilized primary care services within the VA Healthcare Network of Upstate New York. Primary care provider-diagnosed International Statistical Classification of Diseases and Related Health Problems, Revision 9 (ICD-9) physical diseases were examined. Results: Adjusting for demographic characteristics and clinical factors (e.g., age, gender, depression, and substance use), PTSD was significantly associated with an almost two-fold increase of developing nervous system (odds ratio [OR], 1.98), musculoskeletal disease (OR, 1.84), and signs and ill-defined conditions of disease (OR, 1.78). A diagnosis of PTSD was significantly associated with increased odds of developing circulatory (OR, 1.29), hypertensive (OR, 1.38), and digestive system disease (OR, 1.34). Survival analyses showed that veterans with PTSD experienced early onset disease compared with veterans without PTSD; hypertensive (hazard ratio [HR], 1.56; 95% confidence interval [CI], 1.19–2.04), circulatory, (HR, 1.36; 95% CI, 1.11–1.67), digestive (HR, 1.24; 95% CI, 1.08–1.43), nervous (HR, 1.81; 95% CI, 1.59–2.06), musculoskeletal disease (HR, 1.49; 95% CI, 1.32–1.67), and signs and ill-defined disease (HR, 1.70; 95% CI, 1.51–1.92). Conclusions: PTSD is associated with increased prevalence and onset of physical disease among OEF/OIF veterans within the early years post military service. Rising rates of PTSD may foreshadow an increase in lifespan morbidity and healthcare utilization in the coming years among OEF/OIF veterans.