StrongVeterans.com BlogWhat Are the Mental and Physical Health Effects of Combat in US Military Veterans?

Combat is associated with risk for various occupational, environmental, and toxic exposures. These include harsh climates, austere living conditions, and separation from family and close friends, as well as the potential to endure enemy or friendly fire, engage in active combat, and witness death or serious injury. As a consequence of these circumstances, combat exposure is linked to increased risk for mental health problems such as posttraumatic stress disorder (PTSD), major depression, generalized anxiety disorder (GAD), substance use disorder, and suicidality.

To date, however, no known study has evaluated the prevalence of specific mental and physical health conditions associated with combat exposure in a contemporary, nationally representative sample of US veterans. Such data are critical to understanding the mental and physical health needs of combat veterans and informing screening, monitoring, and treatment practices for this population.

In a recent study, we, along with colleagues, analyzed data from a contemporary, nationally representative sample of US military veterans. We had 2 aims: (1) to identify sociodemographic and military characteristics of combat veterans compared to noncombat veterans and (2) to determine and compare current and lifetime mental health (eg, PTSD, depression) and physical health (eg, cardiovascular disease).

Results revealed that 38% of US veterans have been exposed to combat. Compared to noncombat veterans, combat veterans were younger and were more likely to be male, to have served in the Marine Corps, and to use the Veterans Affairs (VA) health care system as their primary source of health care.

Combat veterans had elevated risk for a broad range of health outcomes. Psychiatric morbidities associated with combat exposure included higher rates of current PTSD (11.1% vs 3.0%) and GAD (10.2% vs 4.7%), as well as suicide attempt (9.9% vs 4.9%) independent of psychiatric morbidities. Physical health morbidities linked to combat included elevated rates of chronic pain (26.4% vs 15.7%) and stroke (5.1% vs 2.7%), as well as greater somatic symptoms such as disrupted sleep.

Younger combat veterans (<60 years old) were more likely than older combat veterans (aged 60 years or older) to screen positive for current PTSD (19.2% vs 4.9%) and suicidal ideation (18.6% vs 6.9%) and to be diagnosed with migraine headaches (12.8% vs 2.1%). Older combat veterans were more likely to have been diagnosed with heart disease (19.2% vs 2.6%) and heart attack (13.9% vs 2.5%).

Collectively, these results provide an up-to-date and comprehensive assessment of the mental and physical health burden of combat exposure in US veterans. Combat veterans may face complex mental and physical health issues upon return from deployment, which could affect functioning and quality of life. These findings underscore the importance of identifying, monitoring, and providing treatment for illnesses, tailored to the unique needs of this population in an age- and condition-sensitive manner, in both VA and non-VA health care settings.

Financial disclosure:Ms Thomas and Dr Pietrzak have no relevant personal financial relationships to report.