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Posttraumatic stress disorder and mortality among U.S. Army veterans 30 years after military service.
Ann Epidemiol 2006; 16(4):248-56AE

Abstract

PURPOSE

Research suggests that posttraumatic stress disorder (PTSD) may be associated with later medical morbidity. To assess this, we examined all-cause and cause-specific mortality among a national random sample of U.S. Army veterans with and without PTSD after military service.

METHODS

We used Cox proportional hazards regressions to examine the causes of death among 15,288 male U.S. Army veterans 16 years after completion of a telephone survey, approximately 30 years after their military service. These men were included in a national random sample of veterans from the Vietnam War Era. Our analyses adjusted for race, Army volunteer status, Army entry age, Army discharge status, Army illicit drug abuse, intelligence, age, and, additionally -- for cancer mortality -- pack-years of cigarette smoking.

RESULTS

Our findings indicated that adjusted postwar mortality for all-cause, cardiovascular, cancer, and external causes of death (including motor vehicle accidents, accidental poisonings, suicides, homicides, injuries of undetermined intent) was associated with PTSD among Vietnam Theater veterans (N = 7,924), with hazards ratios (HRs) of 2.2 (p < 0.001), 1.7 (p = 0.034), 1.9 (p = 0.018), and 2.3 (p = 0.001), respectively. For Vietnam Era veterans with no Vietnam service (N = 7,364), PTSD was associated with all-cause mortality (HR = 2.0, p = 0.001). PTSD-positive era veterans also appeared to have an increase in external-cause mortality as well (HR = 2.2, p = 0.073).

CONCLUSIONS

Our study suggests that Vietnam veterans with PTSD may be at increased risk of death from multiple causes. The reasons for this increased mortality are unclear but may be related to biological, psychological, or behavioral factors associated with PTSD and warrant further investigation.

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  • Publisher Full Text

    • Authors+Show Affiliations

    Boscarino JA
    Division of Health and Science Policy, The New York Academy of Medicine, New York, NY 10029, USA. jboscarino@nyam.org

    MeSH

    AdultCardiovascular DiseasesCause of DeathCohort StudiesFollow-Up StudiesHealth StatusHumansMiddle AgedNeoplasmsSmokingStress Disorders, Post-TraumaticSubstance-Related DisordersSurvival AnalysisUnited StatesVeteransVietnamWarfare

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    16099672

    Citation

    Boscarino, Joseph A.. "Posttraumatic Stress Disorder and Mortality Among U.S. Army Veterans 30 Years After Military Service." Annals of Epidemiology, vol. 16, no. 4, 2006, pp. 248-56.
    Boscarino JA. Posttraumatic stress disorder and mortality among U.S. Army veterans 30 years after military service. Ann Epidemiol. 2006;16(4):248-56.
    Boscarino, J. A. (2006). Posttraumatic stress disorder and mortality among U.S. Army veterans 30 years after military service. Annals of Epidemiology, 16(4), pp. 248-56.
    Boscarino JA. Posttraumatic Stress Disorder and Mortality Among U.S. Army Veterans 30 Years After Military Service. Ann Epidemiol. 2006;16(4):248-56. PubMed PMID: 16099672.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Posttraumatic stress disorder and mortality among U.S. Army veterans 30 years after military service. A1 - Boscarino,Joseph A, Y1 - 2005/08/15/ PY - 2005/02/03/received PY - 2005/02/03/revised PY - 2005/03/03/accepted PY - 2005/8/16/pubmed PY - 2006/9/30/medline PY - 2005/8/16/entrez SP - 248 EP - 56 JF - Annals of epidemiology JO - Ann Epidemiol VL - 16 IS - 4 N2 - PURPOSE: Research suggests that posttraumatic stress disorder (PTSD) may be associated with later medical morbidity. To assess this, we examined all-cause and cause-specific mortality among a national random sample of U.S. Army veterans with and without PTSD after military service. METHODS: We used Cox proportional hazards regressions to examine the causes of death among 15,288 male U.S. Army veterans 16 years after completion of a telephone survey, approximately 30 years after their military service. These men were included in a national random sample of veterans from the Vietnam War Era. Our analyses adjusted for race, Army volunteer status, Army entry age, Army discharge status, Army illicit drug abuse, intelligence, age, and, additionally -- for cancer mortality -- pack-years of cigarette smoking. RESULTS: Our findings indicated that adjusted postwar mortality for all-cause, cardiovascular, cancer, and external causes of death (including motor vehicle accidents, accidental poisonings, suicides, homicides, injuries of undetermined intent) was associated with PTSD among Vietnam Theater veterans (N = 7,924), with hazards ratios (HRs) of 2.2 (p < 0.001), 1.7 (p = 0.034), 1.9 (p = 0.018), and 2.3 (p = 0.001), respectively. For Vietnam Era veterans with no Vietnam service (N = 7,364), PTSD was associated with all-cause mortality (HR = 2.0, p = 0.001). PTSD-positive era veterans also appeared to have an increase in external-cause mortality as well (HR = 2.2, p = 0.073). CONCLUSIONS: Our study suggests that Vietnam veterans with PTSD may be at increased risk of death from multiple causes. The reasons for this increased mortality are unclear but may be related to biological, psychological, or behavioral factors associated with PTSD and warrant further investigation. SN - 1047-2797 UR - https://www.unboundmedicine.com/medline/citation/16099672/Posttraumatic_stress_disorder_and_mortality_among_U_S__Army_veterans_30_years_after_military_service_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1047-2797(05)00110-9 DB - PRIME DP - Unbound Medicine ER -