title: The influence of physical and mental health symptoms on Veterans' functional health status.
abstract: Veterans who have been deployed to combat often have complex medical histories including some combination of traumatic brain injury (TBI); mental health problems; and other chronic, medically unexplained symptoms (i.e., chronic multisymptom illness [CMI] clusters). How these multiple pathologies relate to functional health is unclear. In the current study, 120 Veterans (across multiple combat cohorts) underwent comprehensive clinical evaluations and completed self-report assessments of mental health symptoms (Patient Health Questionnaire-2 [PHQ-2], PTSD Checklist-Civilian Version [PCL-C]) and functional health (Veterans Rand 36-Item Health Survey). Canonical correlation and regression modeling using split-sample permutation tests revealed that the PHQ-2/PCL-C composite variable (among TBI severity and number of problematic CMI clusters) was the primary predictor of multiple functional health domains. Two subscales, Bodily Pain and General Health, were associated with multiple predictors (TBI, PHQ-2/PCL-C, and CMI; and PHQ-2/PCL-C and CMI, respectively), demonstrating the multifaceted nature of how distinct medical problems might uniquely and collectively impair aspects of functional health. Apart from these findings, however, TBI and CMI were not predictors of any other aspects of functional health. Taken together, our findings suggest that mental health problems might exert ubiquitous influence over multiple domains of functional health. Thus, screening of mental health problems and education and promotion of mental health resources can be important to the treatment and care of Veterans.
authors.affiliation: War Related Illness and Injury Study Center, VA Palo Alto Health Care System, Palo Alto, CA.|Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA.
authors.forename: Tong
authors.initials: T
authors.lastname: Sheng
authors.affiliation: War Related Illness and Injury Study Center, VA Palo Alto Health Care System, Palo Alto, CA.|Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA.
authors.forename: J Kaci
authors.initials: JK
authors.lastname: Fairchild
authors.affiliation: School of Social Work, Boston University, Boston, MA.
authors.forename: Jennifer Y
authors.initials: JY
authors.lastname: Kong
authors.affiliation: War Related Illness and Injury Study Center, VA Palo Alto Health Care System, Palo Alto, CA.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Kinoshita
authors.affiliation: War Related Illness and Injury Study Center, VA Palo Alto Health Care System, Palo Alto, CA.|Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA.
authors.forename: Jauhtai J
authors.initials: JJ
authors.lastname: Cheng
authors.affiliation: War Related Illness and Injury Study Center, VA Palo Alto Health Care System, Palo Alto, CA.|Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA.
authors.forename: Jerome A
authors.initials: JA
authors.lastname: Yesavage
authors.affiliation: War Related Illness and Injury Study Center, VA New Jersey Health Care System, East Orange, NJ.
authors.forename: Drew A
authors.initials: DA
authors.lastname: Helmer
authors.affiliation: War Related Illness and Injury Study Center, VA Medical Center, Washington DC.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Reinhard
authors.affiliation: War Related Illness and Injury Study Center, VA Palo Alto Health Care System, Palo Alto, CA.|Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA.
authors.forename: J Wesson
authors.initials: JW
authors.lastname: Ashford
authors.affiliation: War Related Illness and Injury Study Center, VA Palo Alto Health Care System, Palo Alto, CA.|Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA.|Defense and Veterans Brain Injury Center, VA Palo Alto Health Care System, Palo Alto, CA.
authors.forename: Maheen M
authors.initials: MM
authors.lastname: Adamson
mesh_terms: D000328:Adult; D000368:Aged; D000070642:Brain Injuries, Traumatic / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014728:Veterans; D058014:Veterans Health
keywords: Veterans; chronic multisymptom illness; daily functioning; functional health; mental health; posttraumatic stress; quality of life; symptoms; traumatic brain injury; war related illness