PTSD and Use of Outpatient General Medical Services Among Veterans of the Vietnam War.

Psychiatr Serv

Dr. Schlenger, Dr. Williams, and Dr. Corry are with Abt Associates, Durham, North Carolina, where Dr. Ho was affiliated when this work was done. Dr. Ho is now with the Department of Business Administration, Shih Hsin University, Taipei, Taiwan. When this work was done, Dr. Mulvaney-Day and Dr. Mauch were with Abt Associates, Cambridge, Massachusetts. Dr. Mulvaney-Day is now with Truven Health Analytics, Cambridge, Massachusetts. Dr. Mauch is now with the Massachusetts Association for Mental Health, Boston. Dr. Kulka is an independent consultant in Raleigh, North Carolina. Ms. Nagler is with Abt Associates, Bethesda, Maryland. Dr. Marmar is with Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, Department of Psychiatry, New York University Langone Medical Center, New York City. Send correspondence to Dr. Mulvaney-Day (e-mail: ).

Published: May 2016

Objective: The primary goal of this analysis was to assess whether recent use of outpatient services for general medical concerns by Vietnam veterans varies according to level of posttraumatic stress disorder (PTSD) symptomatology over time. Another goal was to determine whether PTSD symptomatology was associated with veterans' reports of discussing behavioral health issues as part of a general medical visit.

Methods: Self-reported service use data and measures of PTSD were from a nationally representative sample of 848 male and female Vietnam theater veterans (individuals who were deployed to the Vietnam theater of operations) who participated in the National Vietnam Veterans Longitudinal Study, a 25-year follow-up of a cohort of veterans originally interviewed from 1984-1988 as part of the National Vietnam Veterans Readjustment Study. Four categories of PTSD symptomatology course over 25 years were defined, and logistic regression models were used to assess their relationship with recent use of outpatient general medical services.

Results: Male and female theater veterans with high or increasing PTSD symptomatology over the period were more likely than those with low symptomatology to report recent VA outpatient visits. Males in the increasing and high categories were also more likely to discuss behavioral health issues at general medical visits.

Conclusions: Vietnam veterans with high and increasing PTSD symptomatology over time were likely to use VA outpatient general health services. Attention to stressors of the aging process and to persistence of PTSD symptoms is important for Vietnam veterans, as is addressing PTSD with other psychiatric and medical comorbidities within the context of outpatient general medical care.

Download full-text PDF

Source
http://dx.doi.org/10.1176/appi.ps.201400576DOI Listing

Publication Analysis

Top Keywords

general medical
24
vietnam veterans
20
ptsd symptomatology
20
outpatient general
16
ptsd
9
veterans
9
vietnam
8
symptomatology time
8
behavioral health
8
health issues
8

Similar Publications

Micro- and nanomorphological modification and roughening of titanium implant surfaces can enhance osseointegration; however, the optimal morphology remains unclear. Laser processing of implant surfaces has demonstrated significant potential due to its precision, controllability, and environmental friendliness. Femtosecond lasers, through precise optimization of processing parameters, can modify the surface of any solid material to generate micro- and nanomorphologies of varying scales and roughness.

View Article and Find Full Text PDF

Methyleugenol (ME) has been classified as a "group 2B carcinogen" by IARC. Its positional isomer methylisoeugenol (MIE) has been considered to be of "generally recognized as safe'' status by FDA. ME was more cytotoxic than MIE in cultured mouse primary hepatocytes.

View Article and Find Full Text PDF

Community health workers (CHWs) play a significant role in supporting health services delivery in communities with few trained health care providers. There has been limited research on ways to optimize the role of CHWs in HIV prevention service delivery. This study explored CHWs' experiences with offering HIV prevention services [HIV testing and HIV pre- and post-exposure prophylaxis (PrEP and PEP)] during three pilot studies in rural communities in Kenya and Uganda, which aimed to increase biomedical HIV prevention coverage via a structured patient-centered HIV prevention delivery model.

View Article and Find Full Text PDF

Importance: During buprenorphine treatment for opioid use disorder (OUD), risk factors for opioid relapse or treatment dropout include comorbid substance use disorder, anxiety, or residual opioid craving. There is a need for a well-powered trial to evaluate virtually delivered groups, including both mindfulness and evidence-based approaches, to address these comorbidities during buprenorphine treatment.

Objective: To compare the effects of the Mindful Recovery Opioid Use Disorder Care Continuum (M-ROCC) vs active control among adults receiving buprenorphine for OUD.

View Article and Find Full Text PDF

Importance: Disease characteristics of genetically mediated coronary artery disease (CAD) on coronary angiography and the association of genomic risk with outcomes after coronary angiography are not well understood.

Objective: To assess the angiographic characteristics and risk of post-coronary angiography outcomes of patients with genomic drivers of CAD: familial hypercholesterolemia (FH), high polygenic risk score (PRS), and clonal hematopoiesis of indeterminate potential (CHIP).

Design, Setting, And Participants: A retrospective cohort study of 3518 Mass General Brigham Biobank participants with genomic information who underwent coronary angiography was conducted between July 18, 2000, and August 1, 2023.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!