Psychiatr News August 21, 2009
Volume 44, Number 16, page 1
© 2009 American Psychiatric Association
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Professional News
Army, NIMH Search for Causes of Soldier Suicide Crisis
Aaron Levin
The startling increase in the number of suicides by members of the U.S. Army in the last few years prompts a major collaborative study of risk and protective factors.
The National Institute of Mental Health (NIMH) has tapped a consortium of four research universities to investigate risk and protective factors influencing a troubling increase in suicides in the U.S. Army.
The number of suicides by U.S. soldiers has risen steadily in recent years until levels have equaled those among comparable civilians, who historically have had higher rates. Responding to concern from Congress, the public, and Pentagon officials, the Army allotted $50 million to NIMH for the new study, whose goal is to "provide a science base for effective and practical interventions to reduce suicide rates and address associated mental health problems," according to an NIMH statement.
Such large, longitudinal studies that look at risk and protective factors are unusual in military populations, said Robert Heinssen, Ph.D., acting director of the Division of Services and Intervention Research at NIMH. But the study is unlikely to come up with a single cause for military suicides, he told Psychiatric News.
"[The researchers] are really searching for likely, but weakly linked, risk factors that in combination might create different risk states over time," he said.
The new study will draw on soldiers' personnel and health records and will survey several hundred thousand current soldiers and incoming recruits over the next five years.
The Army now investigates every suicide within the service. It began issuing public reports in 2007 and stated that failed marital or other relationships were most strongly associated with suicide (Psychiatric News, September 21, 2007).
Robert Ursano, M.D., director of the Center for Traumatic Stress Studies at the Uniformed Services University of the Health Sciences (USUHS) in Bethesda, Md., where he also chairs the Department of Psychiatry, will direct the project, the largest ever military study of suicide and mental health.
"This is a unique joining of the Department of Defense and the NIMH to address an issue of national security that will also build tools with peacetime implications," Ursano told Psychiatric News.
His principal collaborators will each add a different area of expertise to USUHS's familiarity with military epidemiology. Stephen Heeringa, Ph.D., of the University of Michigan's Institute for Social Research has experience in securely handling large datasets. Ronald Kessler, Ph.D., of Harvard Medical School is a leading psychiatric epidemiologist, while Columbia University's J. John Mann, M.D., has extensively studied the neurobiology of suicide and the use of the psychological autopsy to examine factors leading up to the event.
The study is a collaborative research project grant, NIMH's term for projects in which the government takes a direct interest beyond routine management, said Heinssen in an interview.
"Two NIMH scientific officers—a psychiatric epidemiologist and a mental health services researcher—will participate as investigators, working on ways to integrate data from surveys with the data the Army routinely collects," said Heinssen.
Several researchers with military backgrounds are also involved in the project, including psychiatric epidemiologist Col. Charles Hoge, director of the Division of Psychiatry and Behavioral Sciences at Walter Reed Army Institute of Research in Silver Spring, Md., and Col. Charles Engel, assistant chair of the Department of Psychiatry at USUHS.
Former APA President Paul Appelbaum, M.D., the Elizabeth K. Dollard Professor of Psychiatry, Medicine, and Law and director of the Division of Psychiatry, Law, and Ethics at the Department of Psychiatry at Columbia University College of Physicians and Surgeons, will chair the project's ethics committee, which faces two primary challenges in a study of military populations: confidentiality of information and voluntariness of consent to protect soldiers from coercion and undue influence.
Four Sources Will Be Tapped
Study data will come from four main sources, beginning with the Army's massive existing records on service personnel. Researchers will also survey 90,000 current service members, including those from the National Guard and Reserves, asking about risk and protective factors, as well as about suicidal ideation and attempts. The 80,000 to 120,000 recruits who join the Army in each of the study's first three years will be asked to complete a similar survey.
Study investigators will also set up a case-control study matching soldiers who attempted or completed suicide in recent years with demographically similar controls.
The project may be analogous to another long-term study of disease-influencing factors.
"The Framingham heart study looked at the roles of lifestyle, behavioral characteristics, and biological functions and came up with a good algorithm for stroke and heart attack," said Heinssen. "With that information, the risk factors in cardiovascular disease became targets for treatment."
Key Results to Get Early Release
The new study will look for and evaluate several personal and community factors that might influence the risk for suicide, including combat exposure, overseas deployments, and unit cohesion. It will also consider intermediate outcomes such as posttraumatic stress disorder, depression, anxiety, divorce, family violence, and substance abuse. An "adaptive survey design" will permit investigators to alter survey questions if necessary to provide more data.
The investigators will not wait to complete the study before passing along any useful results.
"Real-time information can allow the leadership to respond quickly and allocate resources for prevention," said Ursano.
The study will provide unpublished interim reports to the Army every six months over the five-year life of the project. However, researchers may present results through normal peer-reviewed channels in print or at scientific conferences as results reach meaningful levels, said Heinssen.
At least one long-time student of suicide hopes the researchers will look beyond proximate causes.
"I applaud the effort, but they may have to go back earlier in life to find vulnerabilities to suicidal behavior," said Mark Kaplan, Dr.P.H., a professor of community health at Portland State University in Oregon.
Suicide is a rare and complex phenomenon, said Kaplan in an interview. The inevitable access of soldiers to weapons and the desensitization to killing of military training and combat make it simpler for an unhappy soldier to impulsively take his own life, but stoicism and difficulty articulating emotions that are part of American masculine culture are contributing factors too, he said.
Nevertheless, the knowledge gained by the study may be generalizable to broader populations, said another civilian expert.
"I believe it is exciting and a very comprehensive approach to understanding the problems that lead to suicide in the adult population," said psychiatrist Paula Clayton, M.D., medical director of the American Foundation for Suicide Prevention. "I'm grateful to the service for recognizing a problem that needs investigating and for funding this study."
The NIMH press release on the study is posted at
Army, NIMH Search for Causes of Soldier Suicide Crisis
Friday, August 28, 2009
Army, NIMH Search for Causes of Soldier Suicide Crisis
Tuesday, August 25, 2009
New data show depression's stubborn grasp in Minnesota
State clinics reveal their rates of success for treating the mental illness, and the results are sobering.
By MAURA LERNER , Star Tribune
Last update: August 20, 2009 - 9:40 PM
Featured comment
Its fairly obvious Depression isnt the hardest condition to treat, however because of the fact that its a multi-dimensional condition, no one method always … read more works. Anyone who has ever had a SERIOUS depressive episode or such as myself has a long standing history of depression. You cant just pigeonhole it to a prescription based fix, some people actually want someone to talk to... I not saying anyone else posting is wrong or right, but it should be handled on a case by case basis, because the symptoms differ by person. A handful of fluxotein isnt always a broom to sweep the problem away. We're living in a technology based anti-personal society, where peoples feelings of detachment are commonplace. Put down your twitter and hug somebody!
For the first time, Minnesota clinics are publicly reporting their success rates at treating depression. The bad news: Only about 4 percent of patients are considered "in remission" -- or no longer depressed -- after six months of treatment.
Success rates for 54 participating clinics were reported Wednesday by MN Community Measurement, an industry group that tracks health-care quality, and posted on its website, www.mnhealthscores.org.
The top-rated clinic, HealthPartners'-Regions Maplewood, reported that 11 percent of its patients had recovered; six clinics reported zero.
Some of the scores are artificially low because of the difficulty in tracking down patients for follow-up, said Jim Chase, the group's president.
But Chase said he believes this kind of public report card -- the first of its kind for depression care -- will spur clinics to make needed improvements, as it has for diabetes care.
"We think when we make it public, one of the advantages is people see who's doing well," said Chase. "There is research out there that there's a better way to treat patients. We hope by measuring the results that we can drive that change."
The rates were based on how patients responded to a standardized depression questionnaire.
For many reasons, depression has been difficult to treat; many patients stop taking their medications or never fill their prescriptions. A 2003 study found that only one in five people with major depression received adequate care.
In the past few years, dozens of Minnesota clinics have started using a questionnaire, known as the PHQ-9 test, to track the symptoms of depression. It asks patients how often, in the previous two weeks, they've experienced nine common symptoms: from feelings of hopelessness to trouble sleeping to thoughts of harming themselves.
The questionnaire is not universally used, Chase said, but he hopes the new public report card will change that. "What we're expecting is the use rate is going to go up a lot, and that's an important step," he said.
As part of the new program, clinics are supposed to give the test to patients at diagnosis and again six months later, to see if their symptoms improve.
Dr. Michael Trangle, who heads the behavioral health program at HealthPartners, the state's third-largest health insurer and clinic system, said it can be tough to get depressed patients to take the follow-up test, one reason the success rates have been so low. "The cardinal symptoms are not just sadness but a lack of energy, initiative," he said. "It's the quintessential group that doesn't follow up.
"Our system of care as usual is very passive and reactive," Trangle added. "If somebody doesn't schedule an appointment, that's it. We don't reach out." This program, he said, will challenge clinics to stay in touch with those patients and, if they're not getting better, adjust their treatment.
Chase cautioned against reading too much into the initial results. "I don't think you want to interpret it as, gee, only 4 percent are ever getting better," he said. This is just the first step, he said, in an effort to get clinics to start measuring depression care much as they do diabetes care.
He noted that more than 400 Minnesota clinics participate in his group's diabetes scorecard, which tracks how well patients control five key risk factors, such as blood pressure and cholesterol. The success rates have jumped from 4 percent to 19 percent since the clinics started tracking and sharing their results, he said.
Maura Lerner • 612-673-7384
VA gives 1,200 vets wrong diagnosis in letter
VA gives 1,200 vets wrong diagnosis in letter
By P.J. Dickerscheid - The Associated Press
Posted : Monday Aug 24, 2009 21:44:24 EDT
CHARLESTON, W.Va. — Former Air Force Reservist Gale Reid received a letter from the Veterans Affairs Department that told her she had Lou Gehrig's disease, and she immediately put herself through a battery of painful, expensive tests. Five days later, the VA said its "diagnosis" was a mistake.
The Montgomery, Ala., resident was among at least 1,200 veterans who received a letter about disability benefits for ALS, also known as Lou Gehrig's disease, even though they hadn't been diagnosed with the illness, according to the National Gulf War Resource Center. Veterans were initially suspicious of the letters, but still went through the agony not knowing exactly whether they had the fatal disease, which typically kills people within five years.
At least 2,500 letters informing veterans of disability benefits for ALS were sent out, and of those, some 1,200 were a mistake, according to the National Gulf War Resource Center. The wrongly sent letters were supposed to inform veterans of an undiagnosed neurological disorder, according to the Gulf War veterans group, which provides information, support and referrals about illnesses to veterans.
No one knows for sure exactly how many letters were mailed to veterans treated at VA hospitals and how many were a mistake. VA spokeswoman Katie Roberts didn't return telephone messages or an e-mail Monday.
Former Army Sgt. Samuel Hargrove cried Sunday after opening his letter.
"I can't even describe the intensity of my feelings," said the father of two from Henderson, N.C. "With so many health issues that I already have, I didn't know how to approach my family with the news."
So, at first, he didn't. Hargrove later discovered the mistake after talking with fellow veterans in the resource center and online, and he became angry.
Reid was just as upset.
"I've been through a week of hell, emotionally, physically and financially," she said.
Denise Nichols, vice president of the National Gulf War Resource Center, said her group has received calls and e-mails from panicked veterans in Alabama, Florida, Kansas, North Carolina, West Virginia and Wyoming.
"Our fear was this could push somebody over the edge," said Nichols, who was worried the news could lead already fragile veterans to commit suicide. "We don't want that to happen."
Jim Bunker, president of the veterans group, said he talked to someone at the VA and was told the mistake was caused by a coding error. The VA uses more than 8,000 codes for various diseases and illnesses and veterans with undiagnosed neurological disorders, which can range from mild to severe, were accidentally assigned the code for ALS, he said.
ALS is a rapidly progressive disease that attacks the nerve cells responsible for controlling voluntary muscles.
Nichols said she suspected something was amiss because some of the veterans she knew who received the letters did not exhibit any ALS symptoms. Hargrove said he became suspicious because the letter didn't come from his doctor, and Reid said she sought a second opinion even though she believed the letter wasn't the right way to inform patients of a diagnosis.
The veterans groups notified the VA of the problems late last week, and the agency was in the process of calling every person who mistakenly received a letter, Bunker said.
The VA has taken some heavy criticism already this year. In June, Congress questioned the agency over botched colonoscopies at medical centers in Florida, Georgia and Tennessee that may have exposed 10,000 veterans to HIV and other infections. Last month, the VA Medical Center in Philadelphia disclosed that the number of cancer patients receiving incorrect radiation doses had risen to 98 veterans over a six-year period.
The Gulf War veterans group is urging the VA to reimburse any veteran who scheduled additional tests with civilian doctors. Reid said her tests cost about $3,000, though it may take weeks before she finds out how much her private insurance will cover.
"We are trying to work with the VA because we realize it was an error and they were trying to do something right for the people who were diagnosed with ALS," Nichols said. "Basically this was a good effort that ended badly."
Air Force Times article link
Status of VUFT and VCS Lawsuit aginst the VA in the 9th Circuit Court (PTSD Lawsuit)
VCS - VUFT Lawsuit Update:
Class Action Suit: On 12 August we appeared before the 9th Circuit Court of Appeals. An article from the LA Times on 24
August summarizes the results so far < latimes.com/news/nationworld/nation/healthcare/la-me-veterans-suit24-2009aug24,0,1423297.story>
.Case Progress to Date:
7/23/2007Suit filed w/Federal District Court
9/25/2007 Defendant’s Motion to Dismiss
2/11/2208 Motion for Preliminary Injunction
2/25/2008 Preliminary Injunction Hearing
4/21/2008 Trial
6/25/2008 Judgment based on jurisdiction
7/25/2008 Appeal notice filed w/9th Circuit Court of Appeals
12/10/2008 Appeal brief filed
12/15/2008 Swords to Plowshares and Vietnam Veterans of America
file amicus briefs
12/22/2008 Military Spouses for Change and United Spinal Association
file amicus briefs
3/4/2009 Appeal will not be subject to Mediation
4/6/2009 Requested an extension to reply to the DVA response to our
brief
4/22/09 Extension granted to 1 May 2009
5/1/09 Appellants’ Reply Brief filed
6/11/09 Oral Arguments Scheduled for 12 August 2009
8/12/09 Oral arguments
9/1/09 Reply on mediation
Friday, August 14, 2009
Stress of war takes mental toll on military kids
Stress of war takes mental toll on military kids
Children of deployed service members at risk of psychological problems
Archive video
Stress, strain on military families
Jan. 12: The stress of having loved ones serving on the front lines in the military can be especially difficult for children. NBC’s Dawn Fratangelo reports.
Nightly News
Ready for school? Planning checklist
How much homework is too much?
Kids' playgroups can fuel mama drama
How to pack the perfect school lunch
Quiz: Are you a psycho sports parent?
Do you take first day of school photos? E-mail us
Kids and parenting videos
Teen idols too sexed up?
Aug. 10: Singer Miley Cyrus raised eyebrows and concern when she danced around a stripper pole at the Teen Choice Awards. Do teen stars directly influence young girls? NBC’s Dr. Nancy Snyderman talks with a panel.
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Religious runaway finds refuge in Fla.
Separating for the kids
Teens talk about stepfamilies
‘Bumpaholics’: Women who love pregnancy
msnbc.com and NBC News
updated 6:00 p.m. ET, Thurs., Aug 13, 2009
The years-long U.S. commitment in Iraq and Afghanistan is taking a significant toll on the children of service members, who are 2½ times more likely to develop psychological problems than American children in general, new research indicates.
The study, published this week in the Journal of Developmental & Behavioral Pediatrics, found that deployment of a parent was correlated to high stress levels in the parent who remains at home, which it said was linked to greater psychological impact on children.
The findings open a new window on the collateral damage wartime deployment can exact back at home.
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There is abundant research on the effects of deployment and combat on service members themselves, said the researchers, led by Maj. Eric M. Flake, a physician at Madigan Army Medical Center in Tacoma, Wash. However, “few studies have looked at how having a parent deployed during wartime affects children,” they wrote.
Davita Hoffman, a specialist at Pikes Peak Behavioral Health Group in Colorado Springs, Colo., said the stress was compounded by military staffing shortages that lead to multiple deployments for many service members.
“Don’t forget, these families generally move once every three years,” Hoffman said.
When Thane Hounchell’s father was assigned to Barksdale Air Force Base in Shreveport, La., in January, Thane, 17, had to abandon his friends and classes at his high school in Prattville, Ala.
“Military children give up a lot, and the fathers and moms are gone a lot,” said Jana Hounchell, Thane’s mother.
Thane acknowledged that the impact on children like him was very real.
Click for related content
Is the U.S. doing enough to lessen the impact of military parents' depoyment on their children?
“You’re kind of in the military, too,” Thane said. “You’ve got to make sacrifices for your country.”
Children’s stress levels could be ‘toxic’
Military children bear “a complex psychosocial burden,” according to the American Academy of Pediatrics, which agreed that data on the effects of deployment on children were only just beginning to emerge.
Recent data make it clear that children of parents who are deployed during wartime “experience ambiguous loss and stress, often beyond normative levels, that may become toxic if not detected and addressed in a timely manner,” the academy said.
What parents can do
The Military Child Education Coalition, a nonprofit advocacy group, says deployment can be a difficult time, for both parents and the families they leave behind. It offers these tips for military families:
• Stay in touch. Ask about homework, tests and school activities. This will help you feel connected to family life.
• Share details about the deployment. Don’t think you’re doing your children a favor by sparing them the details — they want to know where Mommy or Daddy will be.
• The remaining parent or caregiver must make care to take care of his or her own needs first. Make sure you’re connected to other people through groups on base, community groups, church groups or parent groups, so you will have your own support network.
• If it can be determined, find a concrete way to illustrate how long the deployed parent will be away. One way is to create a paper chain, with each day represented by an individual link.
• Leave remembrances. Photos, especially those of the family together, can be very powerful. Record yourself reading favorite bedtime stories or singing favorite songs. These will be treasured resources while you are away.
Hoffman said many service members were diagnosed with post traumatic stress disorder when they came back home, and “the child will mimic those symptoms the parent has.”
“It’s a classic case of a child acting out what they see from Mom and Dad,” she said.
Master Sgt. Minnie E. Hiller-Cousins, administrator of the Family Assistance Center at the National Guard Armory in Teaneck, N.J., said that in er experience, the stress starts much earlier than that, with the simple loss of daily contact.
Hiller-Cousins, a 30-year veteran of the National Guard, recalled the emotional impact on her 2-year-old grandson when she was deployed to Iraq, where she served for eight months.
“If I close my eyes, I can hear him screaming as the bus was pulling off,” she said.
In the study published this week, Flake and his colleagues noted a report last month that found that children of service members sought outpatient mental health care 2 million times last year, double the number when the war in Iraq began more than six years ago.
When that finding was combined with their research, they concluded that “the stresses of deployment seem to be associated with a heightened risk for psychosocial morbidity in military children.”
Parents’ stress translates to children’s stress
The study questioned the spouses of 101 recently deployed Army personnel, each of whom had at least one child aged 5 to 12. They were asked to provide information about both themselves and their children.
Based on the parents’ responses, Flake and his colleagues concluded that 32 percent of the children were at “high risk” for psychosocial problems, which can include learning disorders; developmental disabilities; and emotional, behavioral and psychosomatic problems. That percentage was about 2½ times higher than the norm for American children of the same age in general.
The immediate factor appeared to be high stress in the parent who remained at home, the study found.
More services lower stress levels
In the study, 42 percent of such parents were found to be under “high-risk levels of parental stress.” Overall, either the child, the parent or both were found to be at risk in 55 percent of the families in the study.
The report noted a correlation between the level of support a family receives and a lowering of risk levels, which led them to recommend that all families of deployed service members should be offered support resources. Currently, they said, such services are more commonly available to families living on military bases.
“Assessing the parents’ levels of stress and support could help in recognizing children at high risk of problems with psychosocial adjustment, allowing them to be targeted for appropriate and timely services and support,” they said.
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That is a message that has long been promoted by the National Military Families Association, a nonprofit organization that provides programs and lobbies lawmakers for better “quality of life” policies for the families of service members.
The association noted what it called “the cumulative effects of eight years of war on children, their families and their communities.” It said it the children of service members deployed in wartime were commonly racked with worry over the safety of both parents and were under intense strain from the upheaval of changing schools and their relationships with service providers.
The group called on the Pentagon and Congress to “adapt to the changing needs of service members and families as they cope with multiple deployments and react to separations, reintegration and the situation of those returning with both visible and invisible wounds.”
“Standardization in delivery, accessibility and funding are essential. Programs should provide for families in all stages of deployment and reach out to them in all geographic locations,” it said. “Families should be given the tools to take greater responsibility for their own readiness.”
Secretary Shinseki Announces Expansion of Counseling for Combat Veterans
Secretary Shinseki Announces Expansion of Counseling for Combat Veterans
Additional 28 New Community Vet Centers
WASHINGTON (August 14, 2009) - Today, Secretary of Veterans Affairs Eric
K. Shinseki announced that combat Veterans will receive readjustment
counseling and other assistance in 28 additional communities across the
country where the Department of Veterans Affairs (VA) will establish Vet
Centers in 2010.
"VA is committed to providing high-quality outreach and readjustment
counseling to all combat Veterans," Secretary Shinseki said. "These 28
new Vet Centers will address the growing need for those services."
The community-based Vet Centers -- already in all 50 states -- are a key
component of VA's mental health program, providing Veterans with mental
health screening and post-traumatic stress disorder (PTSD) counseling.
The existing 232 centers conduct community outreach to offer counseling
on employment, family issues and education to combat Veterans and family
members, as well as bereavement counseling for families of
servicemembers killed on active duty and counseling for Veterans who
were sexually harassed on active duty.
Vet Center services are earned through service in a combat zone or area
of hostility and are provided at no cost to Veterans or their families.
They are staffed by small multi-disciplinary teams, which may include
social workers, psychologists, psychiatric nurses, master's-level
counselors and outreach specialists. Over 70 percent of Vet Center
employees are Veterans themselves, a majority of whom served in combat
zones.
The Vet Center program was established in 1979 by Congress, recognizing
that many Vietnam Veterans were still having readjustment problems. In
2008, the Vet Center program provided over 1.1 million visits to over
167,000 Veterans, including over 53,000 visits by more than 14,500
Veteran families. More information about Vet Centers can be found at
www.vetcenter.va.gov/index.asp.
Communities Receiving New VA Vet Centers
American Samoa
Arizona -- Mohave and Yuma Counties
California -- San Luis Obispo County
Delaware - Sussex County
Florida -Marion, Lake, Collier, Okaloosa and Bay Counties
Georgia - Muscogee and Richmond Counties
Hawaii - Western Oahu
Indiana - St. Joseph County
Louisiana - Rapides Parish
Michigan - Grand Traverse County, also serving Wexford County
Missouri - Boone County
Montana - Cascade and Flathead Counties
Ohio - Stark County
Oregon - Deschutes County
Pennsylvania - Lancaster County
South Carolina - Horry County
Texas - Jefferson and Taylor Counties
Utah - Washington County
Washington - Walla Walla County, also serving Umatilla County, Oregon
Wisconsin - LaCrosse County, also serving Monroe County
Monday, August 10, 2009
PTSD raises heart disease risk in Iraq war vets
Note: Of course the VA Doctors can say what they want, The VA Claim Reps & raters are smarter.
The VA does not recognize it as service connected…majority of the time…Vietnam Vets with PTSD are still waiting for s/c for Heart, hypertension, etc… (s) ColonelDan
PTSD raises heart disease risk in Iraq war vets
Tue Aug 4, 2009 5:15pm EDT
NEW YORK (Reuters Health) - Veterans who come home from Iraq and Afghanistan with posttraumatic stress disorder (PTSD) and other mental health diagnoses are hit with a double whammy: They also have greater risk factors for heart disease, according to a report in the Journal of the American Medical Association.
PTSD related to military service has been linked to heart disease in the past, but, to the authors' knowledge, the present study is the first to examine the association for veterans of the current Iraq and Afghanistan conflicts.
Given the time frame of the recent wars, the authors of the study did not look at heart attacks or other events, but examined risk factors for heart disease instead. PTSD and other mental disorders, such anxiety disorder, more than doubled the risk of tobacco use, for example, which is a well-known risk factor.
The study, by Dr. Beth E. Cohen and colleagues, from Veterans Affairs Medical Center, San Francisco, included more than 300,000 veterans who began using Veterans Affairs healthcare from October 7, 2001 to September 30, 2008.
Most - 88 percent - of the subjects were male and the average age was 31 years.
About a quarter had PTSD. Among those who did, about half also suffered from depression, and more than a quarter suffered from anxiety disorder. About a fifth abused alcohol.
Men with mental disorders other than PTSD were at increased risk for all of the heart disease risk factors studied, including tobacco use, high blood pressure, obesity, and diabetes. All of those risk factors were also elevated in men with PTSD, except diabetes.
In women, PTSD was significantly linked to all of the risk factors studied. Other mental disorders were tied to all of the risk factors except diabetes.
SOURCE: JAMA, August 5, 2009.
PTSD raises heart disease risk in Iraq war vets
