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ASSOCIATION OF MENTAL HEALTH PROBLEMS WITH GASTROINTESTINAL DISORDERS IN IRAQ AND AFGHANISTAN VETERANS

Authors

  • Shira Maguen Ph.D.,

    Corresponding author
    1. San Francisco VA Medical Center, San Francisco, California
    2. Department of Psychiatry, University of California, San Francisco, California
    • Correspondence to: Dr. Shira Maguen, San Francisco VA Medical Center, 4150 Clement Street (116-P), San Francisco, CA 94121. E-mail: Shira.Maguen@va.gov

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  • Erin Madden M.P.H.,

    1. San Francisco VA Medical Center, San Francisco, California
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  • Beth Cohen M.D., M.A.S.,

    1. San Francisco VA Medical Center, San Francisco, California
    2. Department of Medicine, University of California, San Francisco, California
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  • Daniel Bertenthal M.P.H.,

    1. San Francisco VA Medical Center, San Francisco, California
    2. Mental Illness Research, Education & Clinical Center, San Francisco, California
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  • Karen Seal M.D., M.P.H.

    1. San Francisco VA Medical Center, San Francisco, California
    2. Department of Psychiatry, University of California, San Francisco, California
    3. Department of Medicine, University of California, San Francisco, California
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  • Contract grant sponsor: VA Health Sciences Research and Development (HSR&D) Career Development Award; Contract grant sponsor: National Institutes of Health; Contract grant number: K23 HL 094765-01; Contract grant sponsor: Mental Illness Research and Education Clinical Center of the US Veterans Health Administration.

Abstract

Background

Gastrointestinal disorders (GIDs) represent a large public health burden, affecting an estimated 60–70 million Americans annually. Our goal was to examine the relationship between GID and the most common mental health disorders in a national group of newly returning veterans. We also evaluated gender differences in the association of mental health disorders and GID.

Methods

We utilized a retrospective, longitudinal cohort analysis of veterans’ health records. Participants were 603,221 Iraq and Afghanistan veterans who were new users of VA healthcare from October 7, 2001 (start of the war in Afghanistan) to December 31, 2010.

Results

The prevalence of GID in newly returning veterans was nearly 20%, and veterans with a mental health disorder were at least twice as likely to have a GID as those without mental health disorders. For women, the increased risk of all GIDs was greatest among those with depression. Among men, the increased risk of irritable bowel syndrome (IBS) was greatest among those with posttraumatic stress disorder. IBS was the GID most strongly associated with mental health conditions among both genders.

Conclusions

The large proportion of newly returning veterans with GIDs and comorbid mental health diagnoses is concerning. Successful detection and treatment of GIDs associated with mental health disorders will require integrated efforts from primary care and mental health.

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