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Exposure to military trauma related to post-war disease and death in Civil War veterans

Those who were wounded had an increased risk of psychological disease but a lower risk of physical disease, perhaps because only hardy soldiers survived wounds on unsanitary Civil War battlefields, the researchers write.

As part of the analysis, soldiers were placed into quartiles depending on the percentage of their company members who were killed. Those in the second quartile were one and a half times as likely as those in first (lowest) quartile to show signs of cardiac, GI and nervous diseases. "Percentage of company killed is likely a powerful variable because it serves as a proxy for various traumatic stressors, such as witnessing death or dismemberment, handling dead bodies, traumatic loss of comrades, realizing one's own imminent death, killing others and being helpless to prevent others' deaths," the authors write.

This analysis is the first to use objective records to track post-war disease and death over soldiers' lifetimes for any war, they report. The older data gave the researchers an opportunity to follow the soldiers until all of them had died, an impossibility with more modern wars. "We found strong relations between traumatic exposure (including witnessing a larger percentage of company death), comorbid disease, mental health ailments and early death," they conclude. "Unfortunately, it is likely that the deleterious health effects seen in a war conducted more than 130 years ago are applicable to the health and well-being of soldiers fighting wars in the 21st century, as recent studies have suggested." (Arch Gen Psychiatry. 2006;63:193-200. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: This study was supported by a grant from the National Institutes on Aging, Bethesda, Md., as a subgrant from the Center for Population Economics at the University of Chicago and the National Bureau of Economics, Boston, Mass.

Editorial: Soldiers' Struggles Similar Throughout History This analysi
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Contact: Christine Byrd
949-824-9055
JAMA and Archives Journals
6-Feb-2006


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