Citation

Kimbrell T, Pyne JM, Kunik ME, Magruder KM, Petersen NJ, Yu HJ, Hudson TJ, Schulz PE, Qureshi SU. Depress. Anxiety 2011; 28(12): 1086-1090.

Affiliation

Center for Mental Health and Outcomes Research, Central Arkansas Veterans Healthcare System, Little Rock, Arkansas; Department of Psychiatry, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas; VA South Central Mental Illness Research, Education and Clinical Center, Little Rock, Arkansas. timothy.kimbrell@va.gov.

Copyright

(Copyright © 2011, John Wiley and Sons)

DOI

10.1002/da.20850

PMID

21751302

Abstract

Background: To determine whether having received a Purple Heart (PH) or having been diagnosed with posttraumatic stress disorder (PTSD) affected mortality in older veterans. Methods: We compared mortality rates of older veterans with a PH but without PTSD (PH+/PTSD-) to veterans with a PH and PTSD (PH+/PTSD+), veterans without a PH but with PTSD (PH-/PTSD+), and a comparison group without a PH or PTSD (PH-/PTSD-). Administrative data from the Veterans Integrated Service Network 16 were collected between 10/01/97 and 09/30/99 for veterans who were 65 years or older. Proportional hazards regression was used to compare the survival times for the four groups (n = 10,255) from entry into the study until death or study termination (9/30/2008). The Charleson co-morbidity index was used to control for potential co-morbid illness burden differences between the groups. Results: Older veterans with a PH (PH+/PTSD- and PH+/PTSD+) had significantly lower mortality rates than PH-/PTSD- veterans (hazard ratio [HR] = 0.6, 95% confidence interval [CI] 0.5 to 0.6, P<.0001; and HR = 0.5, 95% CI 0.4 to 0.7, P<.0001). The PH-/PTSD+ group had a higher mortality rate than the PH-/PTSD- group (HR = 1.1, 95% CI 1.0 to 1.2, P<.01). Conclusions: Veterans who had PH citations and survived into their seventh decade had half the mortality rate of veterans without PH citations with or without PTSD. Veterans with PTSD but without a PH had a significantly higher mortality rate compared to (PH-/PTSD-). Veterans who suffer combat injury without developing PTSD may provide a useful study population for determining the factors that confer resilience. Depression and Anxiety 0:1-5, 2011. © 2011 Wiley-Liss, Inc.

Language: en