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Association between posttraumatic stress disorder and primary care provider-diagnosed disease among Iraq and Afghanistan veterans.
Psychosom Med. 2010 Jun; 72(5):498-504.PM

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.

Authors+Show Affiliations

Center for Integrated Healthcare, Department of Veterans Affairs Medical Center, Syracuse, NY 13210, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20368471

Citation

Andersen, Judith, et al. "Association Between Posttraumatic Stress Disorder and Primary Care Provider-diagnosed Disease Among Iraq and Afghanistan Veterans." Psychosomatic Medicine, vol. 72, no. 5, 2010, pp. 498-504.
Andersen J, Wade M, Possemato K, et al. Association between posttraumatic stress disorder and primary care provider-diagnosed disease among Iraq and Afghanistan veterans. Psychosom Med. 2010;72(5):498-504.
Andersen, J., Wade, M., Possemato, K., & Ouimette, P. (2010). Association between posttraumatic stress disorder and primary care provider-diagnosed disease among Iraq and Afghanistan veterans. Psychosomatic Medicine, 72(5), 498-504. https://doi.org/10.1097/PSY.0b013e3181d969a1
Andersen J, et al. Association Between Posttraumatic Stress Disorder and Primary Care Provider-diagnosed Disease Among Iraq and Afghanistan Veterans. Psychosom Med. 2010;72(5):498-504. PubMed PMID: 20368471.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association between posttraumatic stress disorder and primary care provider-diagnosed disease among Iraq and Afghanistan veterans. AU - Andersen,Judith, AU - Wade,Michael, AU - Possemato,Kyle, AU - Ouimette,Paige, Y1 - 2010/04/05/ PY - 2010/4/7/entrez PY - 2010/4/7/pubmed PY - 2010/9/2/medline SP - 498 EP - 504 JF - Psychosomatic medicine JO - Psychosom Med VL - 72 IS - 5 N2 - 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. SN - 1534-7796 UR - https://www.unboundmedicine.com/medline/citation/20368471/Association_between_posttraumatic_stress_disorder_and_primary_care_provider_diagnosed_disease_among_Iraq_and_Afghanistan_veterans_ L2 - https://doi.org/10.1097/PSY.0b013e3181d969a1 DB - PRIME DP - Unbound Medicine ER -