Veterans of heavy combat in Vietnam who were diagnosed with post-traumatic stress disorder (PTSD) are significantly more likely to have a host of both chronic and infectious diseases as long as 20 years later, a medical researcher has found.
After studying the medical histories of 1,399 Vietnam veterans, Joseph A. Boscarino, PhD, MPH, vice president for outcomes research with the Sisters of Charity of Nazareth Health System (SCNHS), found that, compared to non-PTSD veterans who saw little combat, those with PTSD who saw heavy combat were 50- 150 percent more likely to have circulatory, digestive, musculoskeletal, respiratory, infectious, and other serious disease 20 years after military service.
The national study, one of the first to confirm a direct link between exposure to traumatic stress and the occurrence of a broad spectrum of diseases many years later, is published in the current issue of Psychosomatic Medicine.
"This research suggests the need to better understand the results of exposure to severe stress in the human disease process," said Boscarino, who noted that the findings may have particular relevance for veterans now suffering from "Gulf War Syndrome." Boscarino urged more research attention on the long-term health status of those in other dangerous occupations, such as firefighters and police officers.
The Vietnam veterans were located by the Centers for Disease Control and Prevention in a random follow-up study of men selected from all U.S. Army veterans of the Vietnam War. The researchers controlled for both pre-service and post-service risk factors for disease, including socioeconomic status, alcohol abuse, cigarette smoking, and other factors.
According to Boscarino, of the 1,399 Vietnam veterans studied, 24 percent (332) were diagnosed with PTSD sometime after military service, and nearly all cases of PTSD in the study resulted from exposure to heavy or very heavy combat in Vietnam.
He said his research and others suggest that those with PTSD often have altered neuroendocrine and sympathetic nervous systems. Disturbances in these key body systems are the main reason for increases in a broad spectrum of diseases among combat veterans, he said. His research also uncovered abnormal immune functioning and clear medical evidence of coronary artery disease among the veterans studied.
The study was funded by the National Institute of Mental Health and the Sisters of Charity of Nazareth Health System (SCNHS), a health network with facilities and programs in Kentucky, Tennessee and Arkansas. On September 1, SCNHS joined Catholic Health Initiatives, a national health care organization based in Denver, Colorado, as its new Southeast Region.
Psychosomatic Medicine is the official peer-reviewed journal of the American Psychosomatic Society, published bi-monthly. For information about the journal, contact Joel E. Dimsdale, MD, editor-in-chief: (619) 543-5468.
Journal
Psychosomatic Medicine