Death From Specific Causes Up for Veterans With PTSD

Among veterans with posttraumatic stress disorder (PTSD), all-cause mortality is elevated, especially death from suicide, accidental injury, and viral hepatitis, according to a study published online June 24 in the American Journal of Preventive Medicine.

Jenna A. Forehand, M.D., M.P.H., from the Veterans Affairs Medical Center in White River Junction, Vermont, and colleagues conducted a retrospective cohort study for all veterans initiating PTSD treatment from fiscal year 2008 to 2013. Mortality within the first year after treatment initiation was the primary outcome. The leading causes of death were determined using data collected in 2018.

The researchers identified 491,040 veterans who initiated PTSD treatment. Overall, 1.1 percent died in the year following treatment initiation. Compared with the U.S. population, all-cause mortality was significantly higher for veterans with PTSD (standardized mortality ratio, 1.05). Veterans with PTSD had significant increases in mortality from suicide, accidental injury, and viral hepatitis (standardized mortality ratios, 2.52, 1.99, and 2.26, respectively) compared with the U.S. population. More than half of those dying from accidental injury died of poisoning (52.3 percent).

"The risk for death from diabetes, chronic liver disease, and viral hepatitis is also high in veterans with PTSD. These conditions are associated with unhealthy lifestyle choices," the authors write. "Therefore, patients with PTSD should receive comprehensive education on the benefits of diet and exercise as well as the risks of chronic stress and substance use."

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