Female Vietnam Vets at Higher Risk for Lifetime/Current PTSD

Pam Harrison

October 07, 2015

Women who served in the Vietnam War are at greater risk for both lifetime and current posttraumatic stress disorder (PTSD) compared with either their counterparts stationed in a nearby base during the same era or with those who served in the United States, new research shows.

Kathryn Magruder, PhD, MPH, Johnson Veterans Affairs Medical Center, Charleston, South Carolina, and lead researcher of the Health of Vietnam-Era Women's Study (HealthVIEWS) found that the lifetime prevalence of PTSD for women in the Vietnam cohort was 20.1%.

This compared with a lifetime prevalence of PTSD of 11.5% in the near-Vietnam cohort and a 14.1% prevalence in the US-based cohort.

The prevalence of current PTSD was also higher among women who had been based in Vietnam during the war, at 15.9%, compared with 8.1% for the near-Vietnam cohort and 9.1% for the US-based cohort.

The estimated lifetime prevalence of PTSD among women in the United States is between 10.4% and 12.3%.

"The excess prevalence of current and lifetime PTSD in the Vietnam cohort is not attributable to premilitary trauma," the investigators note.

"And 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."

The HealthVIEWS study included a total of 4219 women who had served in or near Vietnam or in the United States at any time between July 1965 and March 1973.

Data were collected by mail and by telephone from May 2011 through August 2012.

Most of the women in the Vietnam and the US cohorts were in the Army, whereas about half of the women in the near-Vietnam cohort were in the Air Force.

Women in the Vietnam cohort were more likely to be nurses compared with women in the US cohort (P < .001).

For the Vietnam cohort, lifetime PTSD prevalence attributable to military or postmilitary trauma was 16.9%, compared with 8.5% for the near-Vietnam cohort and 8.9% for their US counterparts, investigators note.

"Most telling, sexual discrimination or harassment, which is not thought of as a unique war zone exposure, was higher among deployed women and significantly related to PTSD in every model," the investigators write.

"Women identified for our study represent, to our knowledge, the most comprehensive cohort of women veterans who served during the Vietnam era, including the largest enumeration of women who served near Vietnam to date.

"Earlier and improved interventions may help to avert the late-life mental health consequences of military service for this next generation of military women," they add.

During the Vietnam era, approximately 5000 to 7500 American women served in the US military in Vietnam, and at least 2000 others were stationed at nearby bases.

An estimated one quarter of a million women were stationed in the United States.

Although women were excluded from combat during the Vietnam War, women in Vietnam were still in a theater of war, and many of those stationed nearby were exposed to casualties and other stressors.

The study was supported by the Department of Veterans Affairs, the Veterans Health Administration, and the VA Office of Research and Development, Cooperative Studies Program.

JAMA Psychiatry. Published online October 7, 2015.

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