Is the US health system comprehensively meeting the needs of returning veterans? With the recent attention to mental illness in returning soldiers, and post-traumatic stress disorder (PTSD) in particular, little research has focused on the medical care needs of those returning from Operation Enduring Freedom/Operation Iraqi Freedom, according to Dr. Susan Frayne, from the VA Palo Alto Health Care System and Stanford University, and colleagues.
Their research highlights that veterans suffering from PTSD also suffer more medical illnesses than do those with no mental health condition. This effect is even more pronounced in women than in men. The findings, published online in the Journal of General Internal Medicine, suggest that medical treatments may need to be closely integrated with mental health services for this special population just returning from military service.
The authors analyzed data for over 90,000 men and women who use Veterans Health Administration (VHA) services to compare the number of diagnosed medical conditions suffered by returning soldiers with PTSD and by those with no mental health condition.
The majority of both men and women had a diagnosed mental health condition. The burden of medical illness was greater for those with post-traumatic stress disorder than for those with no mental health issues, with women worse off than men. Women with PTSD suffered more medical conditions than did those with no mental health condition -- a median value of 7 conditions versus 4.5, the most frequent of which were lower spine disorders, headache and lower extremity joint disorders.
In men, the picture was similar. Men with PTSD suffered more medical conditions than did those without mental health conditions but the difference was smaller -- a median value of 5 conditions for those with PTSD versus 4 for those with no mental health issues. In men, the most frequent medical conditions were lower spine disorders, lower extremity joint disorders, and hearing problems.
Frayne concludes: "Health delivery systems serving our veterans with post-traumatic stress disorder should align clinical services with their medical care needs, especially for common diagnoses like painful musculoskeletal conditions. Looking to the future, the impetus for early intervention is evident. If we recognize the excess burden of medical illness in veterans with PTSD who have recently returned from active service and we address their health care needs today, the elderly veterans of tomorrow may enjoy better health and quality of life."
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