This article is more than 5 years old. Information may no longer be current.

PTSD significantly affects Vietnam War veterans more than 40 years after service

More than 40 years after the Vietnam War, approximately 271,000 Vietnam theater veterans have current PTSD in addition to subthreshold war-zone PTSD, and of these, one-third also have comorbid major depressive disorder.

“After the inclusion of PTSD in the DSM-III in 1980, many studies of the mental health of Vietnam veterans were conducted… The present study builds on the congressionally mandated National Vietnam Veterans Readjustment Study (NVVRS), implemented from 1984 through 1988 (10 years after the war ended) as the only national probability survey of all Vietnam veterans,” Charles R. Marmar, MD, of New York University Langone Medical Center, and colleagues wrote. “We herein describe findings from the National Vietnam Veterans Longitudinal Study (NVVLS), the first follow-up of the NVVRS, a large probability sample of Vietnam veterans who underwent evaluation more than 25 years ago.”

Charles R. Marmar

The NVVLS included a self-report health questionnaire (n = 1,409), a computer-assisted telephone survey health interview (n = 1,279) and a telephone clinical interview (n = 400) among a nationally representative sample of veterans who served in the Vietnam theater of operations. Assessments were conducted between July 2012 and May 2013.

Based on the Clinician-Administered PTSD Scale for DSM-5, the estimated prevalence of PTSD among male theater veterans was 4.5% (95% CI, 1.7-7.3) and the estimated prevalence of full plus subthreshold PTSD was 10.8% (95% CI, 6.5-15.1). The estimated prevalence of current war-zone PTSD, based on the PTSD Checklist for DSM-5 items, was 11.2% (95% CI, 8.3-14.2).

Among female veterans, estimated prevalence of PTSD was 6.1% (95% CI, 1.8-10.3) and the estimated prevalence of full plus subthreshold PTSD was 8.7% (95% CI, 3.8-13.6). The estimated prevalence of current war-zone PTSD was 6.6% (95% CI, 3.5-9.6).

Estimated prevalence of current non–war-zone PTSD, based on PTSD Checklist for DSM-5 items, was 4.6% among males and 5.1% among female theater veterans.

Among veterans with current war-zone PTSD, 36.7% had comorbid major depression.

Charles W. Hoge

Regarding the course of PTSD, 16% of veterans reported an increase and 7.6% reported a decrease of more than 20 points in Mississippi Scale for Combat-Related PTSD symptoms.

“The NVVLS is a historic achievement confirming the long-term impact of Vietnam service across evolving (or devolving) diagnostic classifications. The study is of vital importance to subsequent generations of war veterans and underscores medical service needs for PTSD and related comorbidities extending decades after service,” Charles W. Hoge, MD, of the Walter Reed Army Institute of Research, wrote in an accompanying editorial. “The study also highlights a need to reconsider changes to the PTSD definition, a definition intimately connected with the Vietnam generation and the foundation for the past 25 years of epidemiologic, neurobiological and clinical knowledge and evidence-based treatment practices.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.