POSTTRAUMATIC-STRESS-DISORDER AND FUNCTIONING AND QUALITY-OF-LIFE OUTCOMES IN A NATIONALLY REPRESENTATIVE SAMPLE OF MALE VIETNAM VETERANS

Objective: Although posttraumatic stress disorder (PTSD) is a highly p revalent and often chronic condition, the relationship between PTSD an d functioning and quality of life remains incompletely understood. Met hod: The authors undertook an archival analysis of data front the Nati onal Vietnam Veterans Readjustment Study. The study subjects consisted of the nationally representative sample of male Vietnam veterans who participated in the National Vietnam Veterans Readjustment Study. The authors estimated PTSB at the time of the interview with the Mississip i Scale for Combat-Related Posttraumatic Stress Disorder. They examine d the following outcomes: diminished well-being, physical limitations, bed day in the past 2 weeks, compromised physical health status, curr ently not working, and perpetration of violence. Logistic models were used to determine the association between PTSD and outcome; adjustment was made for demographic characteristics and comorbid psychiatric and other medical conditions. Results: The risks of poorer outcome were s ignificantly higher in subjects with PTSD than in subjects without PTS D in five of the six domains. For the outcome domains of physical limi tations, not working, compromised physical health, and diminished well -being, these significantly higher risks persisted even in the most co nservative logistic models that removed the shared effects of comorbid psychiatric and other medical disorders. Conclusions: The suffering a ssociated with combat related-PTSD extends beyond the signs and sympto ms of the disorder to broader areas of functional and social morbidity . The significantly higher risk of impaired functioning and diminished quality of life uniquely attributable to PTSD suggests that PTSD may well be the core problem in this group of difficult to treat and multi ply afflicted patients.