Friday, September 4, 2015

Vietnam War Veterans Still Face PTSD, Depression 40 Years Later

Forty years later, an estimated 271,000 veterans of the Vietnam War have current posttraumatic stress disorder (PTSD) or subthreshold PTSD—one-third of whom also have current major depressive disorder, according to the National Vietnam Veterans Longitudinal Study (NVVLS), published in the September issue of JAMA Psychiatry.

The NVVLS reassessed a sample of 2,348 veterans who were first studied 25 years ago as part of the National Vietnam Veterans Readjustment Study (NVVRS). For the study, researchers used a variety of instruments to evaluate PTSD and depression, including the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) and the PTSD Checklist for DSM-IV supplemented with PTSD Checklist for DSM-5 items (PCL-5+).

Among male theater veterans, the researchers estimate a current prevalence of war-zone PTSD based on CAPS-5 criteria of 4.5% or 10.8% for current full plus subthreshold PTSD, and 11.8% prevalence based on the PCL-5. For female veterans, the equivalent rates were 6.1%, 8.7%, and 6.6%. PTSD rates were lower for veterans who were posted elsewhere than Vietnam.

The course of the disorder was different between veterans who did and did not serve in Vietnam, said lead author Charles Marmar, M.D., a professor and chairman in the Department of Psychiatry at the New York University School of Medicine. “For era veterans, self-reports of PTSD symptoms during 25 years are low and stable, whereas, for theater veterans, mean levels are higher and increasing.”

The study shows the need for increased access to care and for “anticipating challenges that lie ahead for Iraq and Afghanistan veterans,” Marmar and his colleagues concluded.

“No other study has achieved this quality of longitudinal information, and the sobering findings tell us as much about the Vietnam generation as about the lifelong impact of combat service in general, relevant to all generations,” commented Charles Hoge, M.D., of the Center for Psychiatry and Neuroscience at the Walter Reed Army Institute of Research in Silver Spring, Md., in an accompanying editorial.

For more about the psychiatric effects of military service, see the Psychiatric News article “Troops Face Complex, but Not Inevitable, Mental Health Issues.”

(Image: Orhan Cam/Shutterstock)


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