The impact of PTSD, depression, and substance use disorders on disease burden and health care utilization among OEF/OIF veterans.

Abstract

Growing evidence suggests that posttraumatic stress disorder (PTSD) is associated with poorer health status (e.g., more medical disease, physical symptoms, and sick visits to health care professionals) among veterans who served in Operation Enduring Freedom (OEF) in Afghanistan and Operation Iraqi Freedom (OIF) in Iraq. We investigated whether PTSD, depression, and substance use disorders independently predicted health status over time among OEF/OIF veterans. Information regarding psychiatric and medical conditions and health care utilization was culled for 4,463 OEF/OIF veterans enrolled in Veterans Administration primary care for a period of 6 years. Data were analyzed using multilevel modeling and generalized estimating equations. Results suggest that PTSD, depression, and substance use disorders are independently associated with increased medical disease burden and mental health care utilization but not increased medical health care utilization. The association between PTSD and medical disease burden strengthened over time. These data suggest that OEF/OIF veterans with PTSD may be at risk for increasingly poorer physical health in terms of medical disease burden over time.

The Deployment Life Study: Longitudinal Analysis of Military Families Across the Deployment Cycle

“…In general, fewer than half of those who have deployed and report symptoms indicating that they could benefit from mental health services actually receive such care (Gorman et al, 2011;Pietrzak et al, 2009;Schell and Tanielian, 2011). There is some evidence that greater symptom severity increases treatment-seeking (Balderrama-Durbin et al, 2013;Cohen, Gima, et al, 2010;Possemato et al, 2010;Whealin et al, 2014). Some of the more commonly endorsed reasons about why those who might benefit from treatment don't get it are: difficulty scheduling an appointment or getting time off, stigma, and treatment costs Elnitsky et al, 2013;Schell and Tanielian, 2011).…”

Effectiveness of Cognitive Processing Therapy and Prolonged Exposure in the Department of Veterans Affairs

“…People with PTSD are at an increased risk for many physical health problems including digestive problems, problems with the nervous system, memory loss, fatigue, and knee and joint problems (Possemato, Wade, Andersen, & Ouimette, 2010). The impact of PTSD on physical health can last for many decades (Boscarino, 1997).…”

Current and Projected Characteristics and Unique Health Care Needs of the Patient Population Served by the Department of Veterans Affairs

“…Afghanistan and Iraq Veterans with PTSD are using VA health care more frequently than Veterans of other eras (Elbogen et al, 2013;Shiner, Drake, Watts, Desai, & Schnurr, 2012). Data suggest that Afghanistan and Iraq Veterans with PTSD may also be at increased risk for poorer physical health in terms of medical disease burden (Possemato, Wade, Andersen, & Ouimette, 2010).…”