Citation

Bohnert KM, Ilgen MA, Rosen CS, Desai RA, Austin K, Blow FC. Drug Alcohol Depend. 2013; 128(1-2): 98-103.

Affiliation

Serious Mental Illness Treatment Resource and Evaluation Center, VA Ann Arbor Healthcare System, MI 48109, USA; Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA. Electronic address: kiplingb@med.umich.edu.

Copyright

(Copyright © 2013, Elsevier Publishing)

DOI

10.1016/j.drugalcdep.2012.08.015

PMID

22974491

Abstract

BACKGROUND: Prior studies of Veterans have linked posttraumatic stress disorder (PTSD) with an increased risk of mortality. Other studies of Veterans have found that substance use disorders (SUDs) are associated with an excess risk of mortality among those with psychiatric disorders. It is not known whether having an SUD increases the risk of mortality among Veterans with PTSD, and whether the association differs by mortality type or varies by age cohort. METHODS: A cohort of patients who received Veterans Health Administration services during fiscal year (FY) 2004 and diagnosed with PTSD (n=272,509) were followed from FY 2005 through FY 2007 for the main outcomes of mortality and cause of death. RESULTS: SUD was positively associated with mortality during follow-up (adjusted hazards ratio: 1.70; 95% confidence interval: 1.64, 1.77). SUD was a stronger predictor of non-injury-related mortality for the <45 years group compared with the 45-64 or ≥65 group. SUD predicted injury-related mortality for all age groups. CONCLUSIONS: Among Veterans with PTSD, the association between SUD and mortality was most pronounced for the youngest age group, which included Iraq/Afghanistan Veterans. For older age groups, which included Vietnam-era Veterans, SUD was a greater predictor of injury-related mortality. The findings could be useful for identifying PTSD patients at excess risk of mortality.

Language: en