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 PTSD has previously been linked to increased risk for chronic health
problems like heart disease, diabetes and immune disorders as well
as a greater risk of premature death, researchers note in the
American Journal of Preventive Medicine. But studies to date haven't
offered a clear picture of what causes might be driving higher
mortality rates among veterans with PTSD.
For the current study, researchers examined data on about 491,000
veterans who initiated treatment for PTSD between 2008 and 2013. In
the year following the start of treatment, just over 5,200, or 1.1%,
of the veterans died - a mortality rate 5% higher than for the
general U.S. population of the same age and sex.
In particular, veterans with PTSD were roughly twice as likely to
die of viral hepatitis and more than twice as likely to die of
suicide or accidental injuries than counterparts in the general
population.
"Although prior literature has demonstrated an elevated risk for
death from suicide among veterans with PTSD, we were surprised to
find that veterans with PTSD also have an elevated risk for death
from accidental injury and viral hepatitis," said Dr. Jenna
Forehand, a researcher at the Veterans Affairs Medical Center in
White River Junction, Vermont, who led the study.
"These findings suggest that behavioral factors may contribute to
the excess mortality risk," Forehand said by email.
More than half of the deaths from accidental injuries in the study
were due to poisoning, and one quarter involved motor vehicle
crashes.
Two of the more common types of viral hepatitis can be caused by
certain risky behaviors like intravenous drug use or unprotected
sex.
Diabetes and chronic liver disease also contributed to more deaths
for veterans with PTSD than for their counterparts in the general
population.
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Veterans in the study ranged in age from 18 to over 65, with an
average for the group of 48.5 years old. They all sought care at a
VA health facility, which may mean they're sicker than other
veterans who were not treated within the VA system, the study team
notes.
During the first year of VA treatment, younger veterans with PTSD
were more likely to die of accidental injuries or suicide, while
middle-aged and older veterans were more apt to die of
cardiovascular disease or cancer.
One limitation of the study is that researchers didn't compare
mortality rates for veterans with and without PTSD, said Dr. Charles
Hoge, a senior scientist at the Walter Reed Army Institute of
Research in Silver Spring, Maryland, who wasn't involved in the
study.
"Thus, there is no way to know if the differences in causes of death
are directly attributable to the PTSD diagnosis," Hoge said by
email.
Still, it's not surprising that the cumulative stressors of life as
a veteran with PTSD might make them more vulnerable to risky
behaviors or chronic health problems that lead to an early grave,
said Yu-Chu Shen a researcher at the Naval Postgraduate School in
Monterey, California, who wasn't involved in the study.
"Long exposure to stressors, especially those suffered by veterans
with PTSD, will lead to destructive behaviors and premature deaths,"
Shen said by email. "Reducing the stressors is the key to help this
vulnerable population."
SOURCE: https://bit.ly/2xfLueC American Journal of Preventive
Medicine, online June 24, 2019.
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