After the event

November 2014

FocusAfter the event

Post-traumatic stress disorder in veterans

Volume 43, No.11, November 2014 Pages 753-753

Janice Charles

Christopher Harrison

Helena Britt

Over 2000 general practice encounters per year (2.3%) in BEACH are with repatriation health card holders, referred to here as veterans.1 The patients are veterans of Australia’s defence force or war widows, widowers or dependent children.2 We compared the rate at which post-traumatic stress disorder (PTSD) was managed among veterans and non-veterans from April 2009 to June 2014.

More than 500 000 encounters were recorded in BEACH over the study period and 12 380 of those encounters were with patients who had a repatriation health card. Half of these veterans (50.2%) were aged 85 years or over and another 26.1% were aged 75–84 years. One in five (19.8%) were 55–74 years and almost 4% were 18–54 years. Males accounted for 48% of the sample. We analysed patients by these age and sex groups.

PTSD management rates

PTSD was managed at 8.9% of encounters with male veterans aged 18–54 years, which was significantly more often than at encounters with non-veterans (0.3%). The same result was found for males aged 55–74 years (4.5% compared with 0.1%) and those aged 75–84 years (0.6% for veterans and 0.02% for non-veterans). A similar trend was seen for the younger female veterans, but the sample size lacked enough power to reach significance (Figure 1).

Post Traumatic1
Figure 1. Proportion of GP encounters where PTSD was managed: veterans and non-veterans

 

Our sample of veterans is of necessity limited to those who hold a repatriation health card. The card is issued by the Department of Veterans’ Affairs to former members of Australia’s defence force and their dependants who are deemed ‘entitled to treatment’, and to all veterans aged 70 years and over.2 This will have affected the age distribution reported here. Also, the higher attendance rates among elderly patients in general may have lessened the relative rate of PTSD management found in the older age groups.

Our findings agree with past studies showing that Vietnam veterans (those aged 55–74 years) have elevated levels of PTSD.3 The high rate among veterans in the 18–54 age group, which includes men and women who have served in the Middle East and Afghanistan, should be kept in mind by general practitioners when managing veterans’ health.

References

  1. Britt H, Miller GC, Henderson J, et al. General practice activity in Australia 2013–14. General practice series no. 36. Sydney: Sydney University Press, 2014.
  2. Australian Government Department of Veteran’s Affairs. DVA Factsheet 160. Available at http://factsheets.dva.gov.au/ [Accessed 19 September 2014].
  3. O’Toole B, Marshall RP, Grayson DA, et al. The Australian Vietnam Veterans Health Study: III. psychological health of Australian Vietnam veterans and its relationship to combat. Int J Epidemiol 1996;25:331-40.

Acknowledgements

The authors thank the GP participants in the BEACH program and all members of the BEACH team. Financial contributors to BEACH 2009–2014: Australian Government Department of Health and Ageing; Australian Government Department of Veterans’ Affairs; Abbott Australasia Pty Ltd; AstraZeneca Pty Ltd (Australia); Bayer Australia Ltd; CSL Biotherapies Pty Ltd; GlaxoSmithKline Australia Pty Ltd; Janssen-Cilag Pty Ltd; Merck, Sharp and Dohme (Australia) Pty Ltd; National Prescribing Service Ltd; Novartis Pharmaceuticals Australia Pty Ltd; Pfizer Australia Pty Ltd; Sanofi-Aventis Australia Pty Ltd; Wyeth Australia Pty Ltd.

Correspondence afp@racgp.org.au

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