title: Association between posttraumatic stress disorder and primary care provider-diagnosed disease among Iraq and Afghanistan veterans.
abstract: OBJECTIVE
  To determine if a diagnosis of posttraumatic stress disorder (PTSD) was associated with primary care provider-diagnosed physical disease in the first 5 years post deployment.
  
  
  METHODS
  An examination of medical records of 4416 veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) was conducted. Participants were veterans who served between September 11, 2001 and December 31, 2007, without prior combat exposure, and who utilized primary care services within the VA Healthcare Network of Upstate New York. Primary care provider-diagnosed International Statistical Classification of Diseases and Related Health Problems, Revision 9 (ICD-9) physical diseases were examined.
  
  
  RESULTS
  Adjusting for demographic characteristics and clinical factors (e.g., age, gender, depression, and substance use), PTSD was significantly associated with an almost two-fold increase of developing nervous system (odds ratio [OR], 1.98), musculoskeletal disease (OR, 1.84), and signs and ill-defined conditions of disease (OR, 1.78). A diagnosis of PTSD was significantly associated with increased odds of developing circulatory (OR, 1.29), hypertensive (OR, 1.38), and digestive system disease (OR, 1.34). Survival analyses showed that veterans with PTSD experienced early onset disease compared with veterans without PTSD; hypertensive (hazard ratio [HR], 1.56; 95% confidence interval [CI], 1.19-2.04), circulatory, (HR, 1.36; 95% CI, 1.11-1.67), digestive (HR, 1.24; 95% CI, 1.08-1.43), nervous (HR, 1.81; 95% CI, 1.59-2.06), musculoskeletal disease (HR, 1.49; 95% CI, 1.32-1.67), and signs and ill-defined disease (HR, 1.70; 95% CI, 1.51-1.92).
  
  
  CONCLUSIONS
  PTSD is associated with increased prevalence and onset of physical disease among OEF/OIF veterans within the early years post military service. Rising rates of PTSD may foreshadow an increase in lifespan morbidity and healthcare utilization in the coming years among OEF/OIF veterans.
authors.affiliation: Center for Integrated Healthcare, Department of Veterans Affairs Medical Center, Syracuse, NY 13210, USA.
authors.forename: Judith
authors.initials: J
authors.lastname: Andersen
authors.forename: Michael
authors.initials: M
authors.lastname: Wade
authors.forename: Kyle
authors.initials: K
authors.lastname: Possemato
authors.forename: Paige
authors.initials: P
authors.lastname: Ouimette
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D003130:Combat Disorders / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D019538:Health Care Surveys / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D038801:International Classification of Diseases; D054542:Iraq War, 2003-2011; D008297:Male; D009017:Morbidity; D009518:New York / Q000453:epidemiology; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology*; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*