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Estimating the Disease Burden of Combat-Related Posttraumatic Stress Disorder in United States Veterans and Military Service Members

  • M. C. Freed
  • R. K. Goldberg
  • K. L. Gore
  • C. C. Engel

Abstract:

 Posttraumatic stress disorder (PTSD) is chronic, disabling, but treatable and potentially preventable anxiety disorder characterized by re-experiencing, avoidance, and hyperarousal symptoms following a traumatic event. The World Health Organization (WHO) characterized disease burden in the general population and listed PTSD among the top 20 most “burdensome” diseases. The WHO Global Burden of Disease study estimated a  disability weights for PTSD of 0.11 (0 = perfect health; 1 = dead), but other studies have estimated weights up to 0.66, a figure closer to estimates for severe major depression. Limited research exists on the disease burden of PTSD, and to date, no literature estimated the disease burden of combat-related PTSD in the US military and Veterans Affairs (VA) healthcare systems. Extant PTSD literature is arguably sufficient in scope and content needed to calculate reasonable estimates of disease burden of PTSD in these populations. We review five key components to estimating the disease burden of PTSD in the US military and VA: disorder  prevalence; course of illness; disability weights; impact on the healthcare system; and prevention and treatment efficacy.

Current PTSD prevalence estimates vary, but range from 4.2 to 24.5% in  servicemembers returning from Operation Iraqi and Enduring Freedom, depending on the subpopulation and assessment method. PTSD often develops months to years after traumatic exposure, and 40% of Vietnam veterans with PTSD reported symptom chronicity over 20 years. PTSD is associated with low quality of life, high rates of medical service utilization, interpersonal conflict, co-morbidity, and work impairment compared to persons without PTSD.

PTSD is a chronic, disabling, but treatable and perhaps preventable condition. Disease burden estimates of PTSD could be used to better determine the need for and utility of therapeutic interventions designed to alleviate symptoms of PTSD and associated impairment.

Keywords

Veteran Affair Disease Burden Health Utility Standard Gamble Preference Weight 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of Abbreviations:

CS

cross sectional

DALY

disability adjusted life year

DI

diagnostic interview

DoD

department of defense

DSM

diagnostic and statistics manual

GBD

global burden of disease

IOM

Institute of Medicine

L

longitudinal

MOS SF

36 medical outcome survey short form-36

MRR

medical record review

NRC

National Research Council

OEF

operation enduring freedom

OIF

operation Iraqi freedom

OR

odds ratio

P

Probability

PC-PTSD

primary care- posttraumatic stress disorder (screen)

PCL

posttraumatic stress disorder check list

PDHA

post-deployment health assessment

PDHRA

post-deployment health re-assessment

PTO

 person tradeoff

PTSD

posttraumatic stress disorder

QALY

 quality adjusted life year

SF-6D

short form-6 dimensional health state classification

SRS

self-report screen

SUD

substance used disorder

US

United States

VA

veterans affairs

VHA

veterans health administration

WHO

World Health Organization

YLD

year of life with disability

YLL

years of life lost

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Copyright information

© Springer Science+Business Media LLC 2010

Authors and Affiliations

  • M. C. Freed
  • R. K. Goldberg
  • K. L. Gore
  • C. C. Engel

There are no affiliations available

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