Joel Yager, MD reviewing Murdoch M et al. J Trauma Stress 2017 Feb.

In a longitudinal study, about 10% of men and 20% of women who had applied for PTSD-related disability benefits had persistent serious mental illness.

Nearly one third of the entire Veterans' Affairs (VA) budget is allocated to veterans' disabilities; about 650,000 veterans receive disability benefits for post-traumatic stress disorder (PTSD). In a previous study, nearly a quarter of applicants for PTSD disability benefits reported manic and/or psychotic symptoms. To ascertain the impairment burden of similar veterans, investigators studied VA records of 2580 veterans (59% women) who had applied for VA benefits for PTSD between 1994 and 1998.

Participants had been on active duty during or after the Vietnam conflict. About 90% of men but fewer than 25% of women had served during the Vietnam era. Persistent serious mental illness (PSMI) was defined as diagnoses for schizophrenia, schizoaffective disorder, or bipolar disorders that were recorded in three separate calendar years. PSMI was recorded in 10% of men vs. 22% of women; >80% of those with PSMI had persistent PTSD. Depressive disorders were recorded in 71% of men vs. 79% of women, and anxiety disorders were recorded in 40% vs. 51%.

The investigators then focused on 1728 veterans who returned surveys at three time points (1998–2000, 2004–2006, and 2011–2012). Serious social role impairments and PTSD symptoms across time were reported by nearly 90% with PSMI. Employment at any point was reported by <10% of men and ≤20% of women with PTSD and PSMI.

CITATION(S):

Murdoch M et al. Persistent serious mental illness among former applicants for VA PTSD disability benefits and long-term outcomes: Symptoms, functioning, and employment. J Trauma Stress 2017 Feb; 30:36.

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