Posttraumatic Stress Disorder and Health-Related Quality of Life among a Sample of Treatment- and Pension-Seeking Deployed Canadian Forces Peacekeeping Veterans

Abstract

W La Revue canadienne de psychiatrie, vol 53, no 9, septembre 2008 594Objectives: To examine the health-related quality of life (HRQOL) in deployed Canadian Forces peacekeeping veterans, addressing associations with posttraumatic stress disorder (PTSD), and depression severity.Methods: Participants (n = 125) were consecutive male veterans who were referred for a psychiatric assessment. Instruments administered included the Clinician-Administered PTSD Scale, Hamilton Depression Scale, Short-Form-36 Health Survey, and sociodemographic characteristics.Results: Mental HRQOL was significantly lower for peacekeepers with, than without, PTSD. Using univariate analyses, PTSD and depression severity were each significantly negatively related to mental HRQOL. In sequential regression analyses controlling for age, we found that PTSD and depression severity significantly predicted both mental and physical HRQOL. Conclusions:Veterans with PTSD have significant impairments in mental and physical HRQOL. This information is useful for clinicians and Veterans Affairs administrators working with the newer generation of veterans, as it stresses the importance of including measures of quality of life in the psychiatric evaluation of veterans to better address their rehabilitation needs.Can J Psychiatry 2008;53(9):594-600 Clinical Implications· Veterans with significant symptoms of PTSD and depression present with significant physical and mental impairment. · Understanding the functional impairment in veterans with PTSD can assist with rehabilitation. · It is important to include measures of quality of life in the comprehensive evaluation of veterans to better address their health care needs. Limitations· A male sample of veterans with a service-related disability limits generalizability. · HRQOL was based on the Short-Form-36 Health Survey. · Inherent to a cross-sectional study, at best we can establish an association but not causality.

Posttraumatic Stress Disorder and Health-Related Quality of Life in Pension-Seeking Canadian World War II and Korean War Veterans

“…Consistent with previous studies, [34][35][36][37][38] our results illustrate the significant association between PTSD and HRQoL, especially in the scales measuring emotional well-being. The degree of functional impairment was similar to that found among patients with both serious medical and psychiatric diseases.…”

“…The additional association found in this study between depression and HRQoL on scales measuring severity of mental and physical health impairment is consistent with studies of depression and HRQoL 34,38 and highlights the importance of assessing for depression, which often presents with PTSD. 44 Depression may also be an independent effect of trauma exposure that may independently contribute to impaired HRQoL.…”

War Veterans' Quality of Life: The Impact of Lifetime Traumatic Experiences, Psychological and Physical Health-Related Characteristics

“…QoL in all domains was rated better by non-PTSD than PTSD veterans. Richardson et al (2008) found that veterans with PTSD have significant impairments in mental and physical health--related quality of life (HRQoL). Mental HRQoL was significantly lower for peacemakers with, than without, PTSD.…”

“…Most of the individuals who experience trauma may not meet full diagnostic criteria for PTSD, but may still have clinically significant symptoms that affect their psychological functioning, physical health, and social relations, which is often called partial PTSD. Although the majority of individuals exposed to trauma will not develop or maintain PTSD reactions, subthreshold reactions should not be overlooked (Yehuda et al, 1995;Dimić et al, 2004;Žigrović, 2007;Ajduković et al, 2007.;Richardson et al, 2008). The consequences of traumatization are also evident in other aspects of mental health, primarily in the increase of depression, anxiety and addiction (Pizarro et al, 2006;Basoglu et al, 2005;De Jong et al, 2003;Johansen et al, 2007).…”

Psychiatric Management of Military- Related PTSD: Focus on Psychopharmacology

“…Studies indicate that military-related PTSD is more prone to somatisation (McFarlane et al, 1994) and is associated with more physical health problems (Boscarino, 1997, Boscarino and Chang, 1999, Schnurr and Jankowski, 1999, Sledjeski et al, 2008, Jakupcak et al, 2008, Sareen et al, 2007. Evidence also shows that PTSD is often associated with significant comorbidity including major depression, substance abuse, suicidality, (Kessler et al, 1995, Keane and Kaloupek, 1997, Keane and Wolfe, 1990, Forbes et al, 2003, Kulka et al, 1990, Gradus et al, 2010, Nepon et al, 2010, Sareen et al, 2005 and chronic disability contributing to impaired quality of life (Mills et al, 2006, Richardson et al, 2008, Richardson et al, 2010. Military personnel are more likely to be exposed to trauma than the general public (Breslau et al, 1991).…”