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PTSD prevalence among female Vietnam veterans affected by service location

Service location significantly influenced odds for PTSD among women who served in the U.S. Armed Forces during the Vietnam War, according to study findings in JAMA Psychiatry.

“During the Vietnam era, approximately 5,000 to 7,500 American women served in the U.S. military in Vietnam, at least 2,000 were at nearby bases (in Japan, the Philippines, Guam, Korea, and Thailand), and 250,000 were in the United States,” Kathryn Magruder, PhD, MPH, of the Mental Health Service, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina, and colleagues wrote. “Although most of the deployed women were nurses, others filled diverse positions (eg, clerical, medical, and personnel). Although excluded from combat, women in Vietnam were still in a war theater, and many of those stationed near Vietnam were exposed to war casualties and other stressors related to being the minority sex.”

To determine the onset and prevalence of lifetime and current PTSD for women who served during the Vietnam era in relation to wartime location, researchers surveyed 8,742 women who were active-duty military personnel in the U.S. Armed Forces between July 4, 1965 and March 28, 1973. Data were obtained from mailed and telephone surveys from May 2011 to August 2012. Lifetime and current PTSD was measured by the Composite International Diagnostic Interview, version 3.0.

The weighted prevalence of lifetime PTSD was 20.1% (95% CI, 18.3-21.8) for women who served in Vietnam, 11.5% (95% CI, 9.1-10.2) for those who served near Vietnam and 14.1% (95% CI, 12.4-15.8) for those who served in the United States.

The weighted prevalence of current PTSD was 15.9% (95% CI, 14.3-17.5) for those who served in Vietnam, 8.1% (95% CI, 6-10.2) for those who served near Vietnam and 9.1% (95% CI, 7.7-10.5) for those who served in the United States.

Among women who served in Vietnam, lifetime PTSD prevalence attributable to military or post-military trauma was 16.9% compared with 8.5% and 8.9% among those who served near Vietnam or in the United States, respectively.

Unadjusted analysis indicated the odds for experiencing PTSD were 1.5 times greater among women who served in Vietnam (OR = 1.53; 95% CI, 1.28-1.83) compared with those who served in the United States.

This effect remained the same when adjusting for military characteristics; however, the effect of Vietnam service was no longer statistically significant when wartime exposures were included in analysis (adjusted OR = 0.94; 95% CI, 0.71-1.24).

Unadjusted analysis indicated women who served in Vietnam were significantly more likely to experience current PTSD (OR = 1.89; 95% CI, 1.53-2.33) compared with those who served in the United States. After adjusting for wartime exposures, the effects of Vietnam service were not statistically significant (aOR = 1.05; 95% CI, 0.75-1.46).

“Vietnam service significantly increased the odds of PTSD relative to U.S. service; this effect appears to be related to wartime exposures, especially sexual discrimination or harassment and job performance pressures. Because current PTSD is still present in many of these women decades after their military service, clinicians who treat them should continue to screen for PTSD symptoms and be sensitive to their noncombat wartime experiences,” Magruder and colleagues wrote. “Future research should examine the effect of military service on the presence of psychiatric disorders other than PTSD and the influence of these disorders on geriatric medical conditions.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.