Skip to main content
Erschienen in: Journal of General Internal Medicine 1/2011

01.01.2011 | Original Research

Medical Care Needs of Returning Veterans with PTSD: Their Other Burden

verfasst von: Susan M. Frayne, MD, MPH, Victor Y. Chiu, BA, Samina Iqbal, MD, Eric A. Berg, MS, Kaajal J. Laungani, BA, Ruth C. Cronkite, PhD, Joanne Pavao, MPH, Rachel Kimerling, PhD

Erschienen in: Journal of General Internal Medicine | Ausgabe 1/2011

Einloggen, um Zugang zu erhalten

ABSTRACT

BACKGROUND

There has been considerable focus on the burden of mental illness (including post-traumatic stress disorder, PTSD) in returning Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans, but little attention to the burden of medical illness in those with PTSD.

OBJECTIVES

(1) Determine whether the burden of medical illness is higher in women and men OEF/OIF veterans with PTSD than in those with No Mental Health Conditions (MHC). (2) Identify conditions common in those with PTSD.

DESIGN

Cross-sectional study using existing databases (Fiscal Year 2006–2007).

SETTING

Veterans Health Administration (VHA) patients nationally.

PATIENTS

All 90,558 OEF/OIF veterans using VHA outpatient care nationally, categorized into strata: PTSD, Stress-Related Disorders, Other MHCs, and No MHC.

MEASUREMENTS

(1) Count of medical conditions; (2) specific medical conditions (from ICD9 codes, using Agency for Health Research and Quality’s Clinical Classifications software framework).

MAIN RESULTS

The median number of medical conditions for women was 7.0 versus 4.5 for those with PTSD versus No MHC (p < 0.001), and for men was 5.0 versus 4.0 (p < 0.001). For PTSD patients, the most frequent conditions among women were lumbosacral spine disorders, headache, and lower extremity joint disorders, and among men were lumbosacral spine disorders, lower extremity joint disorders, and hearing problems. These high frequency conditions were more common in those with PTSD than in those with No MHC.

CONCLUSIONS

Burden of medical illness is greater in women and men OEF/OIF veteran VHA users with PTSD than in those with No MHC. Health delivery systems serving them should align clinical program development with their medical care needs.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Seal KH, Bertenthal D, Miner CR, Sen S, Marmar C. Bringing the war back home: mental health disorders among 103,788 US veterans returning from Iraq and Afghanistan seen at Department of Veterans Affairs facilities. Arch Intern Med. 2007;167(5):476–482.PubMedCrossRef Seal KH, Bertenthal D, Miner CR, Sen S, Marmar C. Bringing the war back home: mental health disorders among 103,788 US veterans returning from Iraq and Afghanistan seen at Department of Veterans Affairs facilities. Arch Intern Med. 2007;167(5):476–482.PubMedCrossRef
2.
Zurück zum Zitat Hoge CW, Auchterlonie JL, Milliken CS. Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan. JAMA. 2006;295(9):1023–1032.PubMedCrossRef Hoge CW, Auchterlonie JL, Milliken CS. Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan. JAMA. 2006;295(9):1023–1032.PubMedCrossRef
3.
Zurück zum Zitat Kang HK, Hyams KC. Mental health care needs among recent war veterans. N Engl J Med. 2005;352(13):1289.PubMedCrossRef Kang HK, Hyams KC. Mental health care needs among recent war veterans. N Engl J Med. 2005;352(13):1289.PubMedCrossRef
4.
Zurück zum Zitat Schnurr PP, Green BL. Trauma and Health, Physical Health Consequences of Exposure to Extreme Stress. Washington, DC: American Psychological Association; 2004.CrossRef Schnurr PP, Green BL. Trauma and Health, Physical Health Consequences of Exposure to Extreme Stress. Washington, DC: American Psychological Association; 2004.CrossRef
5.
Zurück zum Zitat Lang AJ, Rodgers CS, Laffaye C, Satz LE, Dresselhaus TR, Stein MB. Sexual trauma, posttraumatic stress disorder, and health behavior. Behav Med. Winter. 2003;28(4):150–158.CrossRef Lang AJ, Rodgers CS, Laffaye C, Satz LE, Dresselhaus TR, Stein MB. Sexual trauma, posttraumatic stress disorder, and health behavior. Behav Med. Winter. 2003;28(4):150–158.CrossRef
6.
Zurück zum Zitat Geuze E, Westenberg HG, Jochims A, et al. Altered pain processing in veterans with posttraumatic stress disorder. Arch Gen Psychiatry. 2007;64(1):76–85.PubMedCrossRef Geuze E, Westenberg HG, Jochims A, et al. Altered pain processing in veterans with posttraumatic stress disorder. Arch Gen Psychiatry. 2007;64(1):76–85.PubMedCrossRef
7.
Zurück zum Zitat Kimerling R, Ouimette P, Wolfe J, eds. Gender and PTSD. New York: The Guilford Press; 2002. Kimerling R, Ouimette P, Wolfe J, eds. Gender and PTSD. New York: The Guilford Press; 2002.
8.
Zurück zum Zitat Friedman MJ, Schnurr PP, McDonagh-Coyle A. Post-traumatic stress disorder in the military veteran. Psychiatr Clin North Am. 1994;17(2):265–277.PubMed Friedman MJ, Schnurr PP, McDonagh-Coyle A. Post-traumatic stress disorder in the military veteran. Psychiatr Clin North Am. 1994;17(2):265–277.PubMed
9.
Zurück zum Zitat Yano EM, Bastian LA, Frayne SM, et al. Toward a VA women’s health research agenda: Setting evidence-based priorities to improve the health and health care of women veterans. J Gen Intern Med. 2006;21(s3):S93–S101.PubMedCrossRef Yano EM, Bastian LA, Frayne SM, et al. Toward a VA women’s health research agenda: Setting evidence-based priorities to improve the health and health care of women veterans. J Gen Intern Med. 2006;21(s3):S93–S101.PubMedCrossRef
10.
Zurück zum Zitat VIREC, VIREC Research User Guide: FY2006 VHA Medical SAS Outpatient Datasets. Hines, IL: Edward J. Hines, Jr. VA Hospital (151 V); September 2007 2007. VIREC, VIREC Research User Guide: FY2006 VHA Medical SAS Outpatient Datasets. Hines, IL: Edward J. Hines, Jr. VA Hospital (151 V); September 2007 2007.
12.
Zurück zum Zitat Kimerling R, Ouimette P, Prins A, et al. Brief report: Utility of a short screening scale for DSM-IV PTSD in primary care. J Gen Intern Med. 2005;21(1):65–67.CrossRef Kimerling R, Ouimette P, Prins A, et al. Brief report: Utility of a short screening scale for DSM-IV PTSD in primary care. J Gen Intern Med. 2005;21(1):65–67.CrossRef
13.
Zurück zum Zitat Schnurr PP, Ford JD, Friedman MJ, Green BL, Dain BJ, Sengupta A. Predictors and outcomes of posttraumatic stress disorder in World War II veterans exposed to mustard gas. J Consult Clin Psychol. 2000;68(2):258–268.PubMedCrossRef Schnurr PP, Ford JD, Friedman MJ, Green BL, Dain BJ, Sengupta A. Predictors and outcomes of posttraumatic stress disorder in World War II veterans exposed to mustard gas. J Consult Clin Psychol. 2000;68(2):258–268.PubMedCrossRef
14.
Zurück zum Zitat Stephens M. EDF statistics for goodness of fit and some comparisons. Journal of the American Statistical Association. 1974;69:730–737.CrossRef Stephens M. EDF statistics for goodness of fit and some comparisons. Journal of the American Statistical Association. 1974;69:730–737.CrossRef
15.
Zurück zum Zitat Beckham JC, Moore SD, Feldman ME, Hertzberg MA, Kirby AC, Fairbank JA. Health status, somatization, and severity of posttraumatic stress disorder in Vietnam combat veterans with posttraumatic stress disorder. Am J Psychiatry. 1998;155(11):1565–1569.PubMed Beckham JC, Moore SD, Feldman ME, Hertzberg MA, Kirby AC, Fairbank JA. Health status, somatization, and severity of posttraumatic stress disorder in Vietnam combat veterans with posttraumatic stress disorder. Am J Psychiatry. 1998;155(11):1565–1569.PubMed
16.
Zurück zum Zitat Frayne SM, Seaver MR, Loveland S, et al. Burden of medical illness in women with depression and posttraumatic stress disorder. Arch Intern Med. 2004;164(12):1306–1312.PubMedCrossRef Frayne SM, Seaver MR, Loveland S, et al. Burden of medical illness in women with depression and posttraumatic stress disorder. Arch Intern Med. 2004;164(12):1306–1312.PubMedCrossRef
17.
Zurück zum Zitat Hoge CW, Terhakopian A, Castro CA, Messer SC, Engel CC. Association of posttraumatic stress disorder with somatic symptoms, health care visits, and absenteeism among Iraq war veterans. Am J Psychiatry. 2007;164(1):150–153.PubMedCrossRef Hoge CW, Terhakopian A, Castro CA, Messer SC, Engel CC. Association of posttraumatic stress disorder with somatic symptoms, health care visits, and absenteeism among Iraq war veterans. Am J Psychiatry. 2007;164(1):150–153.PubMedCrossRef
18.
Zurück zum Zitat Wagner AW, Wolfe J, Rotnitsky A, Proctor SP, Erickson DJ. An investigation of the impact of posttraumatic stress disorder on physical health. J Trauma Stress. 2000;13(1):41–55.PubMedCrossRef Wagner AW, Wolfe J, Rotnitsky A, Proctor SP, Erickson DJ. An investigation of the impact of posttraumatic stress disorder on physical health. J Trauma Stress. 2000;13(1):41–55.PubMedCrossRef
19.
Zurück zum Zitat Wolfe J, Proctor SP, Erickson DJ, et al. Relationship of psychiatric status to Gulf War veterans’ health problems. Psychosom Med. 1999;61(4):532–540.PubMed Wolfe J, Proctor SP, Erickson DJ, et al. Relationship of psychiatric status to Gulf War veterans’ health problems. Psychosom Med. 1999;61(4):532–540.PubMed
20.
Zurück zum Zitat Engel CC Jr, Liu X, McCarthy BD, Miller RF, Ursano R. Relationship of physical symptoms to posttraumatic stress disorder among veterans seeking care for Gulf War-related health concerns. Psychosom Med. 2000;62(6):739–745.PubMed Engel CC Jr, Liu X, McCarthy BD, Miller RF, Ursano R. Relationship of physical symptoms to posttraumatic stress disorder among veterans seeking care for Gulf War-related health concerns. Psychosom Med. 2000;62(6):739–745.PubMed
21.
Zurück zum Zitat Barrett DH, Doebbeling CC, Schwartz DA, et al. Posttraumatic stress disorder and self-reported physical health status among US Military personnel serving during the Gulf War period: a population-based study. Psychosomatics. May-Jun. 2002;43(3):195–205.CrossRef Barrett DH, Doebbeling CC, Schwartz DA, et al. Posttraumatic stress disorder and self-reported physical health status among US Military personnel serving during the Gulf War period: a population-based study. Psychosomatics. May-Jun. 2002;43(3):195–205.CrossRef
22.
Zurück zum Zitat Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, Castro CA. Mild traumatic brain injury in US Soldiers returning from Iraq. N Engl J Med. 2008;358(5):453–463.PubMedCrossRef Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, Castro CA. Mild traumatic brain injury in US Soldiers returning from Iraq. N Engl J Med. 2008;358(5):453–463.PubMedCrossRef
23.
Zurück zum Zitat Cohen BE, Gima K, Bertenthal D, Kim S, Marmar CR, Seal KH. Mental health diagnoses and utilization of VA non-mental health medical services among returning Iraq and Afghanistan veterans. J Gen Intern Med. 2010;25(1):18–24.PubMedCrossRef Cohen BE, Gima K, Bertenthal D, Kim S, Marmar CR, Seal KH. Mental health diagnoses and utilization of VA non-mental health medical services among returning Iraq and Afghanistan veterans. J Gen Intern Med. 2010;25(1):18–24.PubMedCrossRef
24.
Zurück zum Zitat Helmer DA, Chandler HK, Quigley KS, Blatt M, Teichman R, Lange G. Chronic widespread pain, mental health, and physical role function in OEF/OIF veterans. Pain Med. 2009;10(7):1174–1182.PubMedCrossRef Helmer DA, Chandler HK, Quigley KS, Blatt M, Teichman R, Lange G. Chronic widespread pain, mental health, and physical role function in OEF/OIF veterans. Pain Med. 2009;10(7):1174–1182.PubMedCrossRef
25.
Zurück zum Zitat Wolfe J, Schnurr PP, Brown PJ, Furey J. Posttraumatic stress disorder and war-zone exposure as correlates of perceived health in female Vietnam War veterans. J Consult Clin Psychol. 1994;62(6):1235–1240.PubMedCrossRef Wolfe J, Schnurr PP, Brown PJ, Furey J. Posttraumatic stress disorder and war-zone exposure as correlates of perceived health in female Vietnam War veterans. J Consult Clin Psychol. 1994;62(6):1235–1240.PubMedCrossRef
26.
Zurück zum Zitat Taft CT, Stern AS, King LA, King DW. Modeling physical health and functional health status: the role of combat exposure, posttraumatic stress disorder, and personal resource attributes. J Trauma Stress. 1999;12(1):3–23.PubMedCrossRef Taft CT, Stern AS, King LA, King DW. Modeling physical health and functional health status: the role of combat exposure, posttraumatic stress disorder, and personal resource attributes. J Trauma Stress. 1999;12(1):3–23.PubMedCrossRef
27.
Zurück zum Zitat Dobie DJ, Kivlahan DR, Maynard C, Bush KR, Davis TM, Bradley KA. Posttraumatic stress disorder in female veterans: association with self-reported health problems and functional impairment. Arch Intern Med. 2004;164(4):394–400.PubMedCrossRef Dobie DJ, Kivlahan DR, Maynard C, Bush KR, Davis TM, Bradley KA. Posttraumatic stress disorder in female veterans: association with self-reported health problems and functional impairment. Arch Intern Med. 2004;164(4):394–400.PubMedCrossRef
28.
Zurück zum Zitat Kazis LE, Miller DR, Clark J, et al. Health-related quality of life in patients served by the Department of Veterans Affairs: results from the Veterans Health Study. Arch Intern Med. 1998;158(6):626–632.PubMedCrossRef Kazis LE, Miller DR, Clark J, et al. Health-related quality of life in patients served by the Department of Veterans Affairs: results from the Veterans Health Study. Arch Intern Med. 1998;158(6):626–632.PubMedCrossRef
29.
Zurück zum Zitat Redelmeier DA, Tan SH, Booth GL. The treatment of unrelated disorders in patients with chronic medical diseases. N Engl J Med. 1998;338(21):1516–1520.PubMedCrossRef Redelmeier DA, Tan SH, Booth GL. The treatment of unrelated disorders in patients with chronic medical diseases. N Engl J Med. 1998;338(21):1516–1520.PubMedCrossRef
30.
Zurück zum Zitat Schnurr PP, Friedman MJ, Sengupta A, Jankowski MK, Holmes T. PTSD and utilization of medical treatment services among male Vietnam veterans. J Nerv Ment Dis. 2000;188(8):496–504.PubMedCrossRef Schnurr PP, Friedman MJ, Sengupta A, Jankowski MK, Holmes T. PTSD and utilization of medical treatment services among male Vietnam veterans. J Nerv Ment Dis. 2000;188(8):496–504.PubMedCrossRef
31.
Zurück zum Zitat Sheehan B, Lall R, Bass C. Does somatization influence quality of life among older primary care patients? Int J Geriatr Psychiatry. 2005;20(10):967–972.PubMedCrossRef Sheehan B, Lall R, Bass C. Does somatization influence quality of life among older primary care patients? Int J Geriatr Psychiatry. 2005;20(10):967–972.PubMedCrossRef
Metadaten
Titel
Medical Care Needs of Returning Veterans with PTSD: Their Other Burden
verfasst von
Susan M. Frayne, MD, MPH
Victor Y. Chiu, BA
Samina Iqbal, MD
Eric A. Berg, MS
Kaajal J. Laungani, BA
Ruth C. Cronkite, PhD
Joanne Pavao, MPH
Rachel Kimerling, PhD
Publikationsdatum
01.01.2011
Verlag
Springer-Verlag
Erschienen in
Journal of General Internal Medicine / Ausgabe 1/2011
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-010-1497-4

Weitere Artikel der Ausgabe 1/2011

Journal of General Internal Medicine 1/2011 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Vorhofflimmern bei Jüngeren gefährlicher als gedacht

06.05.2024 Vorhofflimmern Nachrichten

Immer mehr jüngere Menschen leiden unter Vorhofflimmern. Betroffene unter 65 Jahren haben viele Risikofaktoren und ein signifikant erhöhtes Sterberisiko verglichen mit Gleichaltrigen ohne die Erkrankung.

Chronisches Koronarsyndrom: Gefahr von Hospitalisierung wegen Herzinsuffizienz

06.05.2024 Herzinsuffizienz Nachrichten

Obwohl ein rezidivierender Herzinfarkt bei chronischem Koronarsyndrom wahrscheinlich die Hauptsorge sowohl der Patienten als auch der Ärzte ist, sind andere Ereignisse womöglich gefährlicher. Laut einer französischen Studie stellt eine Hospitalisation wegen Herzinsuffizienz eine größere Gefahr dar.

„Restriktion auf vier Wochen Therapie bei Schlaflosigkeit ist absurd!“

06.05.2024 Insomnie Nachrichten

Chronische Insomnie als eigenständiges Krankheitsbild ernst nehmen und adäquat nach dem aktuellen Forschungsstand behandeln: Das forderte der Schlafmediziner Dr. Dieter Kunz von der Berliner Charité beim Praxis Update.

GLP-1-Rezeptoragonisten und SGLT-2-Hemmer: zusammen besser

06.05.2024 Typ-2-Diabetes Nachrichten

Immer häufiger wird ein Typ-2-Diabetes sowohl mit einem GLP-1-Rezeptor-Agonisten als auch mit einem SGLT-2-Inhibitor behandelt. Wie sich das verglichen mit den Einzeltherapien auf kardiovaskuläre und renale Komplikationen auswirkt, wurde anhand von Praxisdaten aus Großbritannien untersucht.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.