An estimated 271,000 veterans who served in Vietnam are suffering from post-traumatic stress disorder, according to a study published July in JAMA Psychiatry.
Although it has been 40 years since the war ended, patients with PTSD also had subthreshold warzone PTSD, and more than one-third have current major depressive disorder, the researchers said.
Building on the National Vietnam Veterans Readjustment Study conducted in the mid- to late-1980s, which was a congressionally mandated assessment, researchers found the same veterans and followed up with them. There were 1,839 veterans from the original study still living at the time of the current Vietnam Veterans Longitudinal Study and 78.8% of them participated in at least one phase of the study.
Data analysis was conducted from May 18, 2013, through Jan. 9, 2015, with further analyses continued through April 13, 2015. To obtain data representative of all living Vietnam veterans, prevalence estimates and mean scores were weighted to account for the probability of selection and nonresponse.
Based on self-report health questionnaires, telephone surveys and telephone clinical interviews, authors estimated a prevalence among male war zone veterans of 4.5% for a current PTSD diagnosis; 10.8% based on that assessment plus subthreshold PTSD; and 11.2% based on the PTSD Checklist for current war-zone PTSD. Among female veterans, estimates were 6.1%; 8.7%; and 6.6%, respectively.
Results showed coexisting major depression in 36.7% of veterans with current war-zone PTSD. Of the group, 16% of war zone vets reported an increase of more than 20 points on a PTSD symptom scale while 7.6% reported a decrease of greater than 20 points.
“A substantial prevalence of current subthreshold PTSD represents an important public health concern, given that subthreshold PTSD is associated with levels of dysfunction similar to those in PTSD,” researchers stated. “Our finding that prevalences of clinician diagnoses of comorbid major depression were similar in full and subthreshold groups underscores this concern.”
Researchers concluded that “four decades or longer after their war-zone service, Vietnam theater veterans with current PTSD continue to experience high levels of comorbid depression, consistent with earlier findings.”
They suggested a need for greater access to evidence-based mental health services; integration of mental health treatment into primary care treatment; attention to the stresses of aging, including retirement, chronic illness, declining social support and cognitive changes that create difficulties with the management of unwanted memories; and anticipating challenges that lie ahead for Iraq and Afghanistan veterans.
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