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In a study published in the September/October issue of Women's Health Issues, NCIRE researchers at the San Francisco VA Medical Center and the University of California, San Francisco examined over 71,000 women who served in Iraq and Afghanistan. Using Department of Veterans Affairs (VA) health care records to evaluate the correlation between mental health and reproductive health, the study authors, led by Beth Cohen, MD, MAS, found significantly higher rates of reproductive and physical health problems in those with a mental health diagnosis.

Because women are the fastest-growing demographic within the Veteran population, clinicians and researchers are particularly interested in the ways that military service impacts the minds and bodies of female service members. In an ongoing effort to develop effective treatments for all Veterans, academic research projects that emphasize women Veterans’ health are of particular interest.

“Several important prior studies of the impact of combat service on women have shown a clear association between mental health and physical health problems,” says Dr. Cohen. “Our goal was to build on those findings, focusing on a larger group of women and a broad range of health conditions.”

The researchers analyzed national VA data from over 71,000 women Iraq and Afghanistan Veterans who were new users of VA health care from October 2001 through December 2010.

Veterans were clustered into five groups by mental health diagnoses - women with no mental health diagnosis, women with posttraumatic-stress disorder (PTSD), women with depression, women with comorbid PTSD and depression, and women with a mental health diagnosis other than PTSD and depression.

Of the 71,504 women, 44% received at least one mental health diagnosis. Women Veterans with any mental health diagnosis had a significantly higher prevalence of multiple categories of reproductive and physical disease diagnoses, with prevalence being highest in women with comorbid PTSD and depression.

The findings, which underscore the relationship between mental health and physical wellness, suggest the impact of trauma on women will be a rich area of discovery and a focal point for clinical innovation in the coming years.

"Our Medical Center is committed to meeting the needs of a new generation of women Veterans," said Lawrence Carroll, Director, San Francisco VA Medical Center. "Through our Women's Comprehensive Health Center, we provide services such as reproductive health and mental health services tailored specifically for women. We are aware of the unique issues facing these Veterans and will continue to focus on ensuring our women Veterans receive the high quality health care they deserve."

”The VA has demonstrated a strong commitment to this new generation of women Veterans, with research, pilot programs and new clinical resources to improve health care for women,” concludes Dr. Cohen. ”Hopefully, this study gives us further insight on the unique connection between mental and physical health in female Veterans. This knowledge can help us make strategic research and clinical decisions to best meet the ongoing needs of all of our patients.”

Co-authors of the study are Shira Maguen, PhD, Daniel Bertenthal, MPH, Ying Shi, PhD, Vanessa Jacoby, MD, MAS and Karen H. Seal, MD, MPH.

Dr. Cohen was supported by an NIH/NHLBI grant and a grant from the Irene Perstein Foundation. This work was also financially supported by the Department of Veterans Affairs Health Services Research and Development (HSRD) Research Enhancement Award Program at the San Francisco VA Medical Center.

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December 13, 2016