Link found with post-traumatic stress disorder
Wednesday, March 12, 2003
By K.L. Capozza
The psychological and physical toll of war on veterans' health may be more serious than previously thought.
A new study finds that veterans who experience post-traumatic stress disorder (PTSD) are more likely to suffer from a host of autoimmune diseases that include rheumatoid arthritis, multiple sclerosis and Graves disease.
The findings build on previous research that has shown combat exposure has both physical and psychological health consequences that can be long-lasting and debilitating.
Researchers from the New York Academy of Medicine examined the 20-year medical histories of 1,972 male veterans who served in the U.S. Army during the Vietnam War.
The study found that while 54 men had PTSD, more than double that number had PTSD coupled with another psychiatric disorder such as schizophrenia, depression, paranoia or hysteria, indicating that Vietnam veterans often suffer from multiple mental illnesses.
The data also showed that 17 percent to 19 percent of those with PTSD had an autoimmune disease. Veterans with PTSD and a secondary mental diagnosis had the highest rates of autoimmune disease -- they were three times more likely to develop an autoimmune disease than veterans without it.
"Autoimmune diseases are relatively rare, but they're very devastating. When you look at the PTSD group it tends to jump out at you -- you wonder where is this coming from?" says lead author Dr. Joseph Boscarino, senior scientist at the academy's Division of Health and Science Policy.
Boscarino presented his findings at last weekend's meeting of the American Psychosomatic Society in Phoenix.
PTSD is a common illness among veterans who served in combat, with between 15 percent and 30 percent experiencing the disorder. Symptoms of PTSD include flashbacks, nightmares, anxiety and hyper-arousal.
"This [study] is consistent with the health literature which shows that stress [caused by a traumatic event] is associated with worse health outcomes," says Suzanne Mazzeo, a professor of psychology at Virginia Commonwealth University.
Boscarino says that because the data used in the study are now 15 years old, the prevalence of autoimmune disease among veterans is probably underestimated by his analysis.
"I would expect the prevalence of autoimmune disease among PTSD-positive veterans would be significantly higher if the follow-up exams were conducted today," he says.
Boscarino's findings are good news for Vietnam veterans who often struggle to receive benefits and health-care coverage for disorders that aren't obviously connected to their military service, says Len Selfon, director of the Veterans Benefits Program for the Vietnam Veterans Association of America. Research on the link between psychological illnesses such as PTSD and physical illness is murky, he says.
The U.S. Department of Veterans Affairs (VA) weighs epidemiological and clinical evidence to decide which medical conditions should be covered by the VA's insurance, Selfon says.
This study helps show a medical nexus between PTSD and autoimmune problems that may encourage the VA to apply health-care coverage to these disorders, he says.
"This study is going to be helpful clinically for people being treated for PTSD and autoimmune disease. For the purposes of veterans receiving health care and benefits, it's important to link these disorders," Selfon says.
For more on post-traumatic stress disorder, visit the National Institute of Mental Health. To learn more about autoimmune diseases, check with the National Institute of Allergy and Infectious Diseases.
SOURCES: Joseph Boscarino, senior scientist, division of health and
science policy, New York Academy of Medicine, New York City; Suzanne Mazzeo,
Ph.D., assistant professor, psychology, Virginia Commonwealth University,
Richmond; Len Selfon, director, Veterans Benefits Program, Vietnam Veterans
Association of America, Silver Spring, Md.; March 8, 2003, meeting, American
Psychosomatic Society, Phoenix
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