Gender Differences in Health Service Utilization Among Iraq and Afghanistan Veterans with Posttraumatic Stress Disorder

Maguen, Shira; Cohen, Beth E.; Cohen, Greg; Madden, Erin; Bertenthal, Daniel; Seal, Karen H.

doi:10.1089/jwh.2011.3113

Cited by 68 publications

(61 citation statements)

References 31 publications

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“…It is surprising that our rates of current AUD (11%) and past AUD (39%) were quite low despite general high rates of comorbidity between PTSD and AUD within veterans (Erbes, Westermeyer, Engdahl, & Johnsen, 2007; Maguen, Cohen, Cohen, Madden, Bertenthal, & Seal, 2012; McDevitt-Murphy et al, 2010; Seal et al, 2011). This may reflect the ongoing bias, as discussed above, for providers to avoid referring individuals with AUD to trauma-focused treatment programs, either on their own or as part of an integrated approach to treatment of comorbidity.…”

Section: Discussionmentioning

confidence: 62%

Cognitive Processing Therapy for veterans with comorbid PTSD and alcohol use disorders

Kaysen

Schumm

Pedersen

et al. 2014

Addictive Behaviors

105

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Posttramatic stress disorder (PTSD) and alcohol-use disorders (AUD) frequently present comorbidly in veteran populations. Traditionally those with alcohol dependence have been excluded from PTSD treatment outcome studies, thus we do not know how those with alcohol dependence may tolerate or respond to PTSD-specific interventions; no studies to date have examined the extent to which cognitive PTSD interventions are tolerated or effective for those with comorbid PTSD/AUD. The present study examines the extent to which CPT is tolerated by and effective in treating PTSD symptoms for veterans with PTSD and AUD, as compared to veterans with PTSD only in an outpatient treatment setting. Data were obtained through chart review of 536 veterans diagnosed with PTSD who had received at least 1 session of CPT at a Midwestern US Veterans Affairs hospital. Nearly half (n = 264, 49.3%) of the veterans in the study exhibited a current or past AUD diagnosis. Participants were grouped into the following diagnostic groups: current AUD (past 12 months), past AUD (prior to 12 months), and no AUD. Participants completed an average of 9 sessions of CPT with no significant difference between AUD diagnostic groups on the number of CPT sessions completed. Individuals with past AUD had higher initial symptoms of self-reported PTSD symptoms than those with no AUD. All groups reported significant reductions in PTSD symptoms and depression over time. Overall, the results suggest that CPT appears well tolerated among veterans with comorbid AUD and is associated with significant reductions in symptoms of PTSD and depression in an outpatient treatment setting.

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Section: Discussionmentioning

confidence: 62%

Cognitive Processing Therapy for veterans with comorbid PTSD and alcohol use disorders

Kaysen

Schumm

Pedersen

et al. 2014

Addictive Behaviors

105

View full text Add to dashboard Cite

show abstract

“…Mental health disorder diagnoses were identified using ICD-9 or CPT codes in the MDR data. The following mental health disorder categories were identified using specific ICD-9 codes: any mental health disorder (codes 29, 30, 31); psychotic disorders (codes 295, 297, 298, 293.81, 293.82)(11, 16, 23, 25, 42–44); dementia and other organic psychosis (codes 290, 294)(11, 16); mood disorders (codes 296, 311, 300.4, 309.1, 309.0, 309.4, 301.1, 301.10, 301.12, 301.13)(7, 11, 16, 18, 23, 25, 42–45); substance abuse and dependence disorders (codes 291, 292, 303, 301, 305)(7, 11, 16, 25, 42, 44, 45); anxiety disorders (codes 300 except 300.4, 308.3, 309.81)(25, 42–44), and all other mental health disorders that falls between codes 29 to 31 but not included in any of the above categories.…”

Section: Methodsmentioning

confidence: 99%

The Impact of Preexisting Mental Health Disorders on the Diagnosis, Treatment, and Survival among Lung Cancer Patients in the U.S. Military Health System

Lin

McGlynn

Carter

et al. 2016

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background Higher cancer-related mortality has been observed among people with mental health disorders than in the general population. Both delay in diagnosis and inadequate treatment due to health care access have been found to explain the higher mortality. The U.S. Military Health System (MHS), in which all beneficiaries have equal access to health care, provides an ideal system to study this disparity where there are no or minimal barriers to health care access. This study assessed pre-existing mental health disorders and stage at diagnosis, receipt of cancer treatment and overall survival among non-small cell lung cancer (NSCLC) patients in the U.S. MHS. Methods The study used data from the linked database from the Department of Defense’s Central Cancer Registry and the MHS Data Repository (MDR). The study subjects included 5,054 patients with histologically confirmed primary NSCLC diagnosed between 1998 and 2007. Results Patients with a pre-existing mental disorder did not present with more advanced disease at diagnosis than those without. There were no significant differences in receiving cancer treatments between the two groups. However, patients with a mental health disorder had a higher mortality than those without (Adjusted Hazard ratio (HR) =1.11, 95% CI=1.03 to 1.20). Conclusions Poor survival in NSCLC in patients with a pre-existing mental health disorder is not necessarily associated with delay in diagnosis and/or inadequate cancer treatment. Impact This study contributes to the current understanding that health care access is not sufficient to explain the poor survival among NSCLC patients with pre-existing mental health disorder.

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“…Several studies suggest that among civilians, women are more likely than men to seek treatment after exposure to a traumatic event; 14,15 women veterans of OIF/OEF with PTSD also had higher use of U.S. Department of Veterans' Affairs (VA) health care than men, 17 and military women had higher rates of hospitalization for mental disorders before the wars. 18 However, at least one study of women veterans with military sexual assault and PTSD suggested that they receive fewer health care services.…”

Section: Ptsd and Predictors Of Help Seekingmentioning

confidence: 99%

Gender Differences in Posttraumatic Stress Disorder and Help Seeking in the U.S. Army

Hourani

Williams

Bray

et al. 2016

Journal of Women's Health

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Gender Differences in Health Service Utilization Among Iraq and Afghanistan Veterans with Posttraumatic Stress Disorder

Cited by 68 publications

References 31 publications

Cognitive Processing Therapy for veterans with comorbid PTSD and alcohol use disorders

Cognitive Processing Therapy for veterans with comorbid PTSD and alcohol use disorders

The Impact of Preexisting Mental Health Disorders on the Diagnosis, Treatment, and Survival among Lung Cancer Patients in the U.S. Military Health System

Gender Differences in Posttraumatic Stress Disorder and Help Seeking in the U.S. Army

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