June 24 (UPI) -- For many veterans, life in combat is hard, but for those who survive it, the mental stress of war can be deadly, new research shows.
Veterans with post-traumatic stress disorder have twice the risk of dying from accidental injury, viral hepatitis and suicide compared to the general population, according to a study published Monday in the American Journal of Preventative Medicine. They also have a higher risk of developing chronic liver disease and diabetes.
"Our findings suggest that treatment-seeking veterans with PTSD, including young veterans and women, are dying from largely preventable causes compared with the general population," Jenna A. Forehand, a researcher at the Veterans Affairs Medical Center and study lead investigator, said in a news release.
The retrospective cohort study included more than 490,000 veterans undergoing treatment for PTSD at various Veterans Affairs Medical Centers between 2008 and 2013. During that time, more than 5,200 veterans, at an average age of 48.5, died during their first year of care. About 90 percent of them were males, 63.5 percent were white and nearly 35 percent were deployed in Afghanistan or Iraq.
In the first year of care, younger veterans with PTSD were at risk for suicide and accidental injury from poisoning, while older veterans were likely to die from heart disease or malignant tumors.
In all, 1.1 percent of veterans in the study died a year after starting treatment, representing a 5 percent higher rate than the general population.
Veterans may turn to opioid use to deal with comorbid pain from lingering combat injuries, pain disorders and PTSD sustained in combat. This misuse of opioids, the researchers say, may lead to suicides, accidental injuries and hepatitis-related deaths, particularly among younger veterans.
"Future studies should develop preventative interventions that target PTSD and comorbid depression, pain disorder and substance use to lessen the risk of suicide, accidental poisoning and viral hepatitis in veterans with PTSD," Forehand said. "Similarly, lifestyle modifications may reduce the risk of diabetes and chronic liver disease in this patient population. Veterans seeking treatment for PTSD should receive comprehensive education on the benefits of diet and exercise and the risks of chronic stress and substance use."