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Thousands of veterans of the Vietnam War continue to experience posttraumatic stress disorder tied to war zone experiences that occurred 40 years ago, a new study published in JAMA Psychiatry shows.
“An important minority of Vietnam veterans are symptomatic after 4 decades, with more than twice as many deteriorating as improving,” reported Dr. Charles R. Marmar and his coinvestigators in the National Vietnam Veterans Longitudinal Study (NVVLS) (JAMA Psychiatry 2015 July 22 [(doi:10.1001/jamapsychiatry.015.0803]).
The NVVLS, a follow-up of the original the National Vietnam Veterans Readjustment Study (NVVRS), found that about 271,000 living Vietnam veterans who were deployed into active war zones currently experience PTSD. Furthermore, 36.7% of veterans with current war zone PTSD also suffer from major depressive disorder, reported Dr. Marmar, the Lucius N. Littauer Professor of Psychiatry at of the NYU Langone Medical Center.
A total of 1,839 veterans from NVVRS were alive when NVVLS was undertaken, of which 1,450 (78.8%) participated in at least one phase of the latter study. Dr. Marmar and his coinvestigators estimated that 4.5% (95% confidence interval, 1.7%-7.3%) of male and 6.1% (95% CI, 1.8%-10.3%) of female war zone veterans from the Vietnam War currently have PTSD, based on Clinician-Administered PTSD Scale for DSM-5 PTSD criteria. The prevalence of current PTSD from any cause related to service in Vietnam was estimated at 12.2% for males and 8.5% for females, said Dr. Marmar, also director of PTSD research program and chairman of the department of psychiatry at the NYU School of Medicine.
Meanwhile, Dr. Marmar and his associates found that the prevalence of alcohol and other drug abuse was low in both PTSD and subthreshold PTSD.
“Policy implications include the need for greater access to evidence-based mental health services; the importance of integrating mental health treatment into primary care in light of the nearly 20% mortality; attention to the stresses of aging, including retirement, chronic illness, declining social support, and cognitive changes that create difficulties with the management of unwanted memories; and anticipating challenges that lie ahead for Iraq and Afghanistan veterans,” the authors concluded.
The NVVLS was funded by the Department of Veterans Affairs. The authors did not report any financial disclosures.
“The most important [National Vietnam Veterans Longitudinal Study] finding is confirmation of the chronic and debilitating course of war-related PTSD,” Dr. Charles W. Hoge wrote. Using the Clinician-Administered PTSD Scale for DSM-5, or CAPS-5, Dr. Marmar and his colleagues found lifetime and current war-zone PTSD prevalences of 17.0% and 4.5%, respectively, in male veterans (15.2% and 6.1%, respectively, in female veterans).” These estimates are lower than those found by Bruce P. Dohrenwend, Ph.D., and his colleagues (Science 2006;313:979-82) and probably do not reflect the “full disease burden owing to potential psychometric concerns with the CAPS-5.” Also, almost a quarter of the cohort died in the interim between the National Vietnam Veterans Readjustment Study (NVVRS) and the NVVLS, the National Vietnam Veterans Longitudinal Study.
“In summary, the NVVLS is a historic achievement confirming the long-term impact of Vietnam service across evolving (or devolving) diagnostic classifications,” Dr. Hoge wrote. In addition, the study “underscores medical service needs for PTSD and related comorbidities extending decades after service and highlights a need to reconsider changes to the PTSD definition.”
Dr. Charles W. Hoge is a retired U.S. Army colonel, is affiliated with the Walter Reed Army Institute of Research in Silver Spring, Md., and is an expert on PTSD and traumatic brain injury. These comments are excerpted from his accompanying editorial (JAMA Psychiatry 2015 July 22 [(doi:10.1001/jamapsychiatry.2015.1066]). He reported no conflicts of interest.
“The most important [National Vietnam Veterans Longitudinal Study] finding is confirmation of the chronic and debilitating course of war-related PTSD,” Dr. Charles W. Hoge wrote. Using the Clinician-Administered PTSD Scale for DSM-5, or CAPS-5, Dr. Marmar and his colleagues found lifetime and current war-zone PTSD prevalences of 17.0% and 4.5%, respectively, in male veterans (15.2% and 6.1%, respectively, in female veterans).” These estimates are lower than those found by Bruce P. Dohrenwend, Ph.D., and his colleagues (Science 2006;313:979-82) and probably do not reflect the “full disease burden owing to potential psychometric concerns with the CAPS-5.” Also, almost a quarter of the cohort died in the interim between the National Vietnam Veterans Readjustment Study (NVVRS) and the NVVLS, the National Vietnam Veterans Longitudinal Study.
“In summary, the NVVLS is a historic achievement confirming the long-term impact of Vietnam service across evolving (or devolving) diagnostic classifications,” Dr. Hoge wrote. In addition, the study “underscores medical service needs for PTSD and related comorbidities extending decades after service and highlights a need to reconsider changes to the PTSD definition.”
Dr. Charles W. Hoge is a retired U.S. Army colonel, is affiliated with the Walter Reed Army Institute of Research in Silver Spring, Md., and is an expert on PTSD and traumatic brain injury. These comments are excerpted from his accompanying editorial (JAMA Psychiatry 2015 July 22 [(doi:10.1001/jamapsychiatry.2015.1066]). He reported no conflicts of interest.
“The most important [National Vietnam Veterans Longitudinal Study] finding is confirmation of the chronic and debilitating course of war-related PTSD,” Dr. Charles W. Hoge wrote. Using the Clinician-Administered PTSD Scale for DSM-5, or CAPS-5, Dr. Marmar and his colleagues found lifetime and current war-zone PTSD prevalences of 17.0% and 4.5%, respectively, in male veterans (15.2% and 6.1%, respectively, in female veterans).” These estimates are lower than those found by Bruce P. Dohrenwend, Ph.D., and his colleagues (Science 2006;313:979-82) and probably do not reflect the “full disease burden owing to potential psychometric concerns with the CAPS-5.” Also, almost a quarter of the cohort died in the interim between the National Vietnam Veterans Readjustment Study (NVVRS) and the NVVLS, the National Vietnam Veterans Longitudinal Study.
“In summary, the NVVLS is a historic achievement confirming the long-term impact of Vietnam service across evolving (or devolving) diagnostic classifications,” Dr. Hoge wrote. In addition, the study “underscores medical service needs for PTSD and related comorbidities extending decades after service and highlights a need to reconsider changes to the PTSD definition.”
Dr. Charles W. Hoge is a retired U.S. Army colonel, is affiliated with the Walter Reed Army Institute of Research in Silver Spring, Md., and is an expert on PTSD and traumatic brain injury. These comments are excerpted from his accompanying editorial (JAMA Psychiatry 2015 July 22 [(doi:10.1001/jamapsychiatry.2015.1066]). He reported no conflicts of interest.
Thousands of veterans of the Vietnam War continue to experience posttraumatic stress disorder tied to war zone experiences that occurred 40 years ago, a new study published in JAMA Psychiatry shows.
“An important minority of Vietnam veterans are symptomatic after 4 decades, with more than twice as many deteriorating as improving,” reported Dr. Charles R. Marmar and his coinvestigators in the National Vietnam Veterans Longitudinal Study (NVVLS) (JAMA Psychiatry 2015 July 22 [(doi:10.1001/jamapsychiatry.015.0803]).
The NVVLS, a follow-up of the original the National Vietnam Veterans Readjustment Study (NVVRS), found that about 271,000 living Vietnam veterans who were deployed into active war zones currently experience PTSD. Furthermore, 36.7% of veterans with current war zone PTSD also suffer from major depressive disorder, reported Dr. Marmar, the Lucius N. Littauer Professor of Psychiatry at of the NYU Langone Medical Center.
A total of 1,839 veterans from NVVRS were alive when NVVLS was undertaken, of which 1,450 (78.8%) participated in at least one phase of the latter study. Dr. Marmar and his coinvestigators estimated that 4.5% (95% confidence interval, 1.7%-7.3%) of male and 6.1% (95% CI, 1.8%-10.3%) of female war zone veterans from the Vietnam War currently have PTSD, based on Clinician-Administered PTSD Scale for DSM-5 PTSD criteria. The prevalence of current PTSD from any cause related to service in Vietnam was estimated at 12.2% for males and 8.5% for females, said Dr. Marmar, also director of PTSD research program and chairman of the department of psychiatry at the NYU School of Medicine.
Meanwhile, Dr. Marmar and his associates found that the prevalence of alcohol and other drug abuse was low in both PTSD and subthreshold PTSD.
“Policy implications include the need for greater access to evidence-based mental health services; the importance of integrating mental health treatment into primary care in light of the nearly 20% mortality; attention to the stresses of aging, including retirement, chronic illness, declining social support, and cognitive changes that create difficulties with the management of unwanted memories; and anticipating challenges that lie ahead for Iraq and Afghanistan veterans,” the authors concluded.
The NVVLS was funded by the Department of Veterans Affairs. The authors did not report any financial disclosures.
Thousands of veterans of the Vietnam War continue to experience posttraumatic stress disorder tied to war zone experiences that occurred 40 years ago, a new study published in JAMA Psychiatry shows.
“An important minority of Vietnam veterans are symptomatic after 4 decades, with more than twice as many deteriorating as improving,” reported Dr. Charles R. Marmar and his coinvestigators in the National Vietnam Veterans Longitudinal Study (NVVLS) (JAMA Psychiatry 2015 July 22 [(doi:10.1001/jamapsychiatry.015.0803]).
The NVVLS, a follow-up of the original the National Vietnam Veterans Readjustment Study (NVVRS), found that about 271,000 living Vietnam veterans who were deployed into active war zones currently experience PTSD. Furthermore, 36.7% of veterans with current war zone PTSD also suffer from major depressive disorder, reported Dr. Marmar, the Lucius N. Littauer Professor of Psychiatry at of the NYU Langone Medical Center.
A total of 1,839 veterans from NVVRS were alive when NVVLS was undertaken, of which 1,450 (78.8%) participated in at least one phase of the latter study. Dr. Marmar and his coinvestigators estimated that 4.5% (95% confidence interval, 1.7%-7.3%) of male and 6.1% (95% CI, 1.8%-10.3%) of female war zone veterans from the Vietnam War currently have PTSD, based on Clinician-Administered PTSD Scale for DSM-5 PTSD criteria. The prevalence of current PTSD from any cause related to service in Vietnam was estimated at 12.2% for males and 8.5% for females, said Dr. Marmar, also director of PTSD research program and chairman of the department of psychiatry at the NYU School of Medicine.
Meanwhile, Dr. Marmar and his associates found that the prevalence of alcohol and other drug abuse was low in both PTSD and subthreshold PTSD.
“Policy implications include the need for greater access to evidence-based mental health services; the importance of integrating mental health treatment into primary care in light of the nearly 20% mortality; attention to the stresses of aging, including retirement, chronic illness, declining social support, and cognitive changes that create difficulties with the management of unwanted memories; and anticipating challenges that lie ahead for Iraq and Afghanistan veterans,” the authors concluded.
The NVVLS was funded by the Department of Veterans Affairs. The authors did not report any financial disclosures.
FROM JAMA PSYCHIATRY
Key clinical point: Nearly 271,000 war zone veterans of the Vietnam War currently have full, symptomatic posttraumatic stress disorder.
Major finding: The estimated prevalence of current war zone–related PTSD in male war zone veterans is 4.5% and 6.1% in female war zone veterans.
Data source: The National Vietnam Veterans Longitudinal Study (NVVLS), a congressionally mandated study of 1,839 Vietnam War veterans who also were assessed as part of the National Vietnam Veterans Readjustment Study.
Disclosures: The NVVLS was funded by the Department of Veterans Affairs, and the authors reported no financial disclosures.
