Vietnam veterans who endured heavy combat and were later diagnosed with post-traumatic stress syndrome (PTSD) are significantly more likely than other vets to suffer from a variety of chronic diseases 15 to 20 years later. Compared to soldiers who saw little combat in Vietnam and did not develop PTSD, they are 50% to 150% more likely to develop heart disease, weakened immune systems, infections, arthritis, and respiratory and digestive problems.
All of these problems may arise from a single source--the high state of nervous arousal induced by post-traumatic stress, according to a study published in the current issue of Psychosomatic Medicine. The mere memory of combat can keep PTSD victims constantly "on guard," inducing near-continuous mental and physical tension. That over-arousal causes the endocrine system to pour out a steady stream of hormones and other chemicals, wreaking havoc with the body over a period of years, says author Joseph Boscarino, an epidemiologist and social psychologist with Catholic Health Initiatives, a national hospital chain.
In 1988, the Centers for Disease Control and Prevention (CDC) in Atlanta gave detailed physical exams to almost 4500 of the 4.9 million veterans who had been in the military between 1965 and 1971. CDC staffers found that among those who had served in Vietnam, there were many psychological problems and a few medical problems. But Boscarino, himself a Vietnam veteran, says the CDC's researchers never connected the two, probably because its medical investigators and social scientists worked in separate groups. By separating the soldiers into heavy-combat PTSD and light-combat PTSD groups, he was able to strongly link the serious health problems to combat stress.
The new analysis provides "clear and direct evidence" that PTSD causes physical damage, says Charles Figley, a PTSD expert at Florida State University in Tallahassee. He and Terence Keane, director of the National Center for Post-Traumatic Stress Disorder at the Boston Veterans Administration Health Center, would like to take another look at Vietnam vets to see if their health has worsened since the 1980s. "These guys are 48 to 50 now," Keane says, "and this is the point where you're going to start to see some serious diseases develop."