Association of Posttraumatic Stress Disorder With Somatic Symptoms, Health Care Visits, and Absenteeism Among Iraq War Veterans

Objective: Studies of soldiers from prior wars conducted many years after combat have shown associations between combat-related posttraumatic stress disorder (PTSD) and physical health problems. The current Iraq war has posed a considerable PTSD risk, but the association with physical health has not been well studied. Method: The authors studied 2,863 soldiers using standardized self-administered screening instruments 1 year after their return from combat duty in Iraq. Results: Among all participants, 16.6% met screening criteria for PTSD. PTSD was significantly associated with lower ratings of general health, more sick call visits, more missed workdays, more physical symptoms, and high somatic symptom severity. These results remained significant after control for being wounded or injured. Conclusions: The high prevalence of PTSD and its strong association with physical health problems among Iraq war veterans have important implications for delivery of medical services. The medical burden of PTSD includes physical health problems; combat veterans with serious somatic concerns should be evaluated for PTSD. Abstract Teaser Figures in this Article Research has established a strong relationship between combat-related posttraumatic stress disorder (PTSD) and physical health measures (1–16). This association was observed in veterans from the 1991 Gulf War who experienced increased rates of physical symptoms in all domains in the years after returning from deployment (1, 4–7, 12, 16). Compared to military personnel who were not stationed in the war zone, 1991 Gulf War veterans showed significantly higher rates of somatic symptoms, more psychological distress, worse general health status, and greater health-related physical and psychosocial functional impairment (1). The major limitations of these studies were that they were conducted many years after the veterans returned from combat, were based largely on clinical populations, and did not control for wartime injuries. Research conducted on veterans from the current war in Iraq has already established the presence of a high prevalence of PTSD (12%–13%) during the first 3–4 months after their return home (17). One study conducted among seriously injured hospitalized veterans showed that PTSD was strongly correlated with the level of injury (18). However, to date the relationship between PTSD and physical health has not been explored among healthy noninjured veterans. This study evaluated the association of PTSD with physical health measures among Iraq war veterans 1 year after their return from deployment with control for combat injury

The Psychiatric Genomics Consortium Posttraumatic Stress Disorder Workgroup: Posttraumatic Stress Disorder Enters the Age of Large-Scale Genomic Collaboration

The development of posttraumatic stress disorder (PTSD) is influenced by genetic factors. Although there have been some replicated candidates, the identification of risk variants for PTSD has lagged behind genetic research of other psychiatric disorders such as schizophrenia, autism, and bipolar disorder. Psychiatric genetics has moved beyond examination of specific candidate genes in favor of the genome-wide association study (GWAS) strategy of very large numbers of samples, which allows for the discovery of previously unsuspected genes and molecular pathways. The successes of genetic studies of schizophrenia and bipolar disorder have been aided by the formation of a large-scale GWAS consortium: the Psychiatric Genomics Consortium (PGC). In contrast, only a handful of GWAS of PTSD have appeared in the literature to date. Here we describe the formation of a group dedicated to large-scale study of PTSD genetics: the PGC-PTSD. The PGC-PTSD faces challenges related to the contingency on trauma exposure and the large degree of ancestral genetic diversity within and across participating studies. Using the PGC analysis pipeline supplemented by analyses tailored to address these challenges, we anticipate that our first large-scale GWAS of PTSD will comprise over 10 000 cases and 30 000 trauma-exposed controls. Following in the footsteps of our PGC forerunners, this collaboration—of a scope that is unprecedented in the field of traumatic stress—will lead the search for replicable genetic associations and new insights into the biological underpinnings of PTSD