Researchers led by Charles R. Marmar, M.D., from the Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury at the New York University Langone Medical Center, New York, and other institutions analyzed data from the National Vietnam Veterans Readjustment Study (NVVRS). That survey consisted of a self-report health questionnaire (n=1,409), a computer-assisted telephone survey health interview (n=1,279), and a telephone clinical interview (n=400) in a representative national sample of veterans who served in the Vietnam theater of operations. A total of 1,839 veterans participated in at least one NVVRS study phase.
Study instruments included the Mississippi Scale for Combat-Related PTSD, PTSD Checklist for DSM-IV supplemented with PTSD Checklist for DSM-5 items (PCL-5+), Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), and Structured Clinical Interview for DSM-IV, Nonpatient Version.
They found that among male theater veterans, the prevalence of current PTSD ranged from 4.5% based on CAPS-5 criteria to 11.2% using PCL-5+ criteria. Among female veterans, estimates were between 6.1% and 8.7%. Comorbid major depression occurred in 36.7% of veterans with current war-zone PTSD. With regard to the course of PTSD, 16% of theater veterans reported an increase and 7.6% reported a decrease of greater than 20 points in Mississippi Scale for Combat-Related PTSD symptoms.
“Approximately 271,000 Vietnam theater veterans have current full PTSD plus subthreshold war-zone PTSD, one-third of whom have current major depressive disorder, 40 or more years after the war,” the researchers stated. “These findings underscore the need for mental health services for many decades for veterans with PTSD symptoms.”
In an editorial accompanying the study in JAMA Psychiatry, Charles W. Hoge, M.D., of the Center for Psychiatry and Neuroscience at the Walter Reed Army Institute of Research, said, “The study is of vital importance to subsequent generations of war veterans and underscores medical service needs for PTSD and related comorbidities extending decades after service. The study also highlights a need to reconsider changes to the PTSD definition, a definition intimately connected with the Vietnam generation and the foundation for the past 25 years of epidemiologic, neurobiological, and clinical knowledge and evidence-based treatment practices."
For more information see the Psychiatric News article, "Serious Heart Disease Found in Vietnam Vets With PTSD."
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