Post-traumatic stress disorder, depression, and health-related quality of life in OEF/OIF veterans

Pittman, James O. E.; Goldsmith, Abigail A.; Lemmer, Jennifer A.; Kilmer, Michael T.; Baker, Dewleen G.

doi:10.1007/s11136-011-9918-3

Cited by 82 publications

(65 citation statements)

References 27 publications

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“…Preventing posttraumatic stress disorder (PTSD) is a priority for military healthcare providers because of its adverse effects on health and financial costs [1][2][3][4][5][6][7][8][9]. For patients with serious combat limb injuries, PTSD can complicate and prolong rehabilitation [8].…”

Section: Introductionmentioning

confidence: 99%

“…For patients with serious combat limb injuries, PTSD can complicate and prolong rehabilitation [8]. PTSD is associated with more sick call visits, missed workdays, increased somatic symptoms [3], poor quality of life outcomes [5], and healthcare costs over $1 billion during the first 2 yr after combat injury [7,9]. Although amputations are among the most serious battle injuries, combat amputees injured in the Iraq and Afghanistan wars had reduced likelihood of PTSD compared with limb salvage patients [6].…”

Section: Introductionmentioning

confidence: 99%

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Glasgow Coma Scale scores, early opioids, and 4-year psychological outcomes among combat amputees

et al. 2014

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Abstract-Morphine and fentanyl are frequently used for analgesia after trauma, but there is debate over the advantages and disadvantages of these opioids. Among combat amputees, intravenous (IV) morphine (vs IV fentanyl) after injury was associated with reduced likelihood of posttraumatic stress disorder (PTSD). The previous results were based on military health diagnoses over 2 yr postinjury. The present study followed psychological diagnoses of patients with amputation for 4 yr using military and Department of Veterans Affairs health data. Intheater combat casualty records (n = 145) documented Glasgow Coma Scale (GCS) scores and/or morphine, fentanyl, or no opioid treatment within hours of injury. We found that (1) GCS scores were not significantly associated with PTSD; (2) longitudinal modeling using four (yearly) time points showed significantly reduced odds of PTSD for patients treated with morphine (vs fentanyl) across years (adjusted odds ratio = 0.40; 95% confidence interval = 0.17-0.94); (3) reduced PTSD prevalence for morphine (vs IV fentanyl; morphine = 25%, fentanyl = 59%, p < 0.05) was significant, specifically among patients with traumatic brain injury during the first 2 yr postinjury; and (4) PTSD prevalence, but not other disorders (e.g., mood), increased between year 1 (PTSD = 18%) and years 2 through 4 postinjury (PTSD range = 30%-32%).

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Glasgow Coma Scale scores, early opioids, and 4-year psychological outcomes among combat amputees

et al. 2014

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“…In addition, research indicates that veterans may experience mental health difficulties for as long as 12 years after leaving the Armed Forces (AF) before they seek professional help (Murphy, 2016). Untreated mental health difficulties can be detrimental to veterans’ mental and physical health (Kessler, 2000; Schnurr & Green, 2004), quality of life (Pittman, Goldsmith, Lemmer, Kilmer, & Baker, 2012) and relationships (Shalev, 1997). …”

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confidence: 99%

Pathways into mental health care for UK veterans: a qualitative study

Mellotte

Murphy

Rafferty

et al. 2017

European Journal of Psychotraumatology

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Background: It is well established that veterans suffering from mental health difficulties under use mental health services. Objective: This study aimed to understand more about the barriers that prevent veterans from seeking professional help and the enablers that assist veterans in seeking professional help. It also aimed to explore potential mechanisms to improve veterans’ help-seeking and pathways to care. Method: The study employed a qualitative design whereby 17 veterans who had recently attended specialist veteran mental health services took part in semi-structured interviews. The resultant data were analysed using grounded theory. Results: Participants described two distinct stages to their help-seeking: initial help-seeking and pathways through treatment. Specific barriers and enablers to help-seeking were identified at each stage. Initial barriers included recognizing that there is a problem, self-stigma and anticipated public stigma. Initial enablers included being in crisis, social support, motivation and the media. Treatment pathway barriers included practical factors and negative beliefs about health services and professionals. Treatment pathway enablers included having a diagnosis, being seen in a veteran-specific service and establishing a good therapeutic relationship. Participants provided some suggestions for interventions to improve veterans’ help-seeking in future; these focussed on enhancing both veterans and health professionals’ knowledge regarding mental health difficulties. Conclusions: This study identified a number of barriers and enablers that may impact a veteran’s journey in seeking help from professional services for mental health difficulties. Enablers such as reaching a crisis point, social support, the media, having a diagnosis of PTSD and veteran-specific mental health services appeared to be important in opposing stigma-related beliefs and in supporting veterans to engage in help-seeking behaviours.

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“…Depressive disorders and subsyndromal symptomatology may lower one's capacity to enjoy and positively evaluate quality of life. In a sample of veterans, Pittman, Goldsmith, Lemmer, Kilmer, and Baker (2012) found that depression was a significant predictor of psychological but not physical HRQOL. Transgender older adults have been found to have higher depressive symptomatology (FredriksenGoldsen et al, 2013) and lower mental health quality of life (Fredriksen-Goldsen, Kim, Shiu, Goldsen, & Emlet, 2015), than their nontransgender lesbian, gay, and bisexual counterparts, who themselves experience significantly poorer mental health than their heterosexual age peers (Fredriksen-Goldsen, Kim, Barkan, Muraco, & Hoy-Ellis, 2013).…”

Section: Conceptual Frameworkmentioning

confidence: 96%

Prior Military Service, Identity Stigma, and Mental Health Among Transgender Older Adults

Hoy-Ellis

Shiu

Sullivan

et al. 2017

GERONT

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Purpose of the Study: Converging evidence from large community-based samples, Internet studies, and Veterans Health Administration data suggest that transgender adults have high rates of U.S. military service. However, little is known about the role of prior military service in their mental health later in life, particularly in relation to identity stigma. In this article, we examine relationships between prior military service, identity stigma, and mental health among transgender older adults. Design and Methods: We used a subsample of transgender older adults (n = 183) from the 2014 survey of Aging with Pride: National Health, Aging, and Sexuality/Gender Study (NHAS). We employed weighted multivariate linear models to evaluate the relationships between psychological health-related quality of life (HRQOL), depressive symptomatology (Center for Epidemiological Studies Depression Scale [CES-D] scores), identity stigma, and prior military service, controlling for background characteristics. Results: Identity stigma was significantly related with higher depressive symptomatology and lower psychological HRQOL. Having a history of prior military service significantly predicted lower depressive symptomatology and higher psychological HRQOL. The relationships between psychological HRQOL, identity stigma, and prior military service were largely explained by depressive symptomatology. Prior military service significantly attenuated the relationship between identity stigma and depressive symptomatology. Implications: By identifying the role of military service in the mental health of transgender older adults, this study provides insights into how prior military service may contribute to resilience and positive mental health outcomes. Directions for future research are discussed.Keywords: Veterans, Gender identity, Resilience, Depression, Quality of life Estimating the prevalence of current and former U.S. service members who self-identify as transgender is challenging, yet important to understanding of the effects of military service in this population. The Veterans Health Administration indicates the prevalence of diagnosed gender dysphoria is five times that of prevalence estimates in the general population (Blosnich et al., 2013). Gates and Herman (2014) propose that there are more than 15,000 transgender adults currently serving in the U.S. military. The RAND Report commissioned by the U.S. Department of Defense suggests that of the more than 2.1 million active duty and reserve military personnel, between 2,150 (0.1%) and 10,790 (0.5%) are transgender (Schaefer et al., 2016). Due to the rapidly increasing aging population and the high The Gerontologist cite as : Gerontologist, 2017, Vol. 57, No. S1, S63-S71 doi:10.1093 proportion of veterans among older Americans (more than 50%; Hardy & Reyes, 2016), the number of transgender older adults with a history of military service is likely substantially increasing. In a national community-based survey, 41% of transgender older adults reported having previously serv...

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Post-traumatic stress disorder, depression, and health-related quality of life in OEF/OIF veterans

Cited by 82 publications

References 27 publications

Glasgow Coma Scale scores, early opioids, and 4-year psychological outcomes among combat amputees

Glasgow Coma Scale scores, early opioids, and 4-year psychological outcomes among combat amputees

Pathways into mental health care for UK veterans: a qualitative study

Prior Military Service, Identity Stigma, and Mental Health Among Transgender Older Adults

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