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Veterans of the Iraq and Afghanistan wars suffer alarmingly high rates of post-traumatic stress and other psychiatric disorders, and those afflicted with these conditions are also at increased risk for serious autoimmune illnesses, according to an extensive study by researchers at the San Francisco VA Medical Center (SFVAMC).

Previous studies have found that post-traumatic stress may trigger biological abnormalities and alter immune function, leading to physical disease. Now, the large-scale SFVAMC study links post-traumatic stress disorder (PTSD) to a wide range of physician-diagnosed autoimmune disorders in which the body’s immune system mistakenly attacks healthy tissue. Autoimmune disorders diagnosed more often in Veterans with PTSD included thyroiditis, inflammatory bowel disease, rheumatoid arthritis, multiple sclerosis and lupus erythematosus.

“These are severe and debilitating conditions,” said Aoife O’Donovan, PhD, Society in Science: Branco Weiss Fellow in psychiatry at the SFVMAC and Assistant Professor of Psychiatry at the University of California, San Francisco (UCSF). “Our research underscores the need to identify and treat PTSD and other psychiatric disorders to enhance not only mental but also physical health of our Veterans.”

The study looked at the medical records of 666,269 Iraq and Afghanistan Veterans under age 55 who received care from the VA health system between 2001 and 2011.

The study, “Elevated Risk for Autoimmune Disorders in Iraq and Afganistan Veterans with Posttraumatic Stress Disorder” currently online and to be published in an upcoming  issue of Biological Psychiatry, found:

  • PTSD was diagnosed in 203,766 Veterans (30.6 percent of those in study) and another 129,704 Veterans (19.5 percent) had psychiatric disorders other than PTSD.
  • Among the Veterans in the study, 9,743 (1.5%) were diagnosed with an autoimmune disorder at two or more separate VA medical visits. Veterans with PTSD had twice the risk of being diagnosed later with an autoimmune disorder compared to those without any psychiatric disorders. Veterans with psychiatric disorders other than PTSD had a 51 percent increased risk of developing an autoimmune disorder.
  • Military sexual trauma (MST) was evident in 13 percent of the women Veterans and 0.5 per cent of the men Veterans. Interestingly, MST was associated with increased risk for autoimmune disorders, even when accounting for the presence of psychiatric disorders.

Overall, the study points to the alarming rates of PTSD and other psychiatric disorders in what is a relatively young population, said O’Donovan. Making it worse for these Veterans of recent wars, is that those who develop psychiatric disorders may also experience serious physical ailments.

She emphasized the need for more research to look at immune system activity in Veterans with PTSD and other psychiatric disorders. “Understanding the mechanisms underlying the relationship between trauma exposure and ill health will give us the information we need to develop new treatments for trauma-exposed Veterans and civilians.”

She also highlighted the need to evaluate whether timely and successful treatment of psychiatric disorders can reduce the risk of autoimmune conditions. Co-authors of the study from the SFVAMC were: Beth E, Cohen, MD; Karen H. Seal, MD, MPH; Dan Bertenthal, MPH; Mary Margaretten, MD; Kristen Nishimi; and Thomas C. Neylan, MD.

The study was supported by the Department of Veteran Affairs Mental Illness Research, Education and Clinical Centers; Society in Science – The Branco Weiss Fellowship; National Institutes of Health; and NCIRE – The Veterans Health Research Institute.

SFVAMC has the largest medical research program in the national VA system, with more than 200 research scientists, all of whom are faculty members at UCSF.

NCIRE – The Veterans Health Research Institute is the largest research institute associated with a VA medical center. Its mission is to improve the health and well-being of Veterans and the general public by supporting a world-class biomedical research program conducted by the UCSF faculty at SFVAMC.

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June 2, 2017