Top

Gepubliceerd in:

27-10-2022

Differences in quality-of-life scores across injury categories by mental health status among injured U.S. military service members and veterans

Auteurs: Judith Harbertson, Andrew J. MacGregor, Cameron T. McCabe, Susan L. Eskridge, Sarah M. Jurick, Jessica R. Watrous, Michael R. Galarneau

Gepubliceerd in: Quality of Life Research | Uitgave 2/2023

Abstract

Purpose

Posttraumatic stress disorder (PTSD) and depression are strong predictors of poor health-related quality of life (HRQOL) among injured U.S. military service members (SMs). Patterns of HRQOL between injury categories and injury categories stratified by mental health (MH) symptoms have not been examined. Among deployment-injured SMs and veterans (n = 4353), we examined HRQOL and screening data for PTSD and/or depression within specific injury categories.

Methods

Participants included those enrolled in the Wounded Warrior Recovery Project with complete data for HRQOL (SF-36) from June 2017 to May 2020. Injuries were categorized using the Barell Injury Diagnosis Matrix (Barell Matrix). Mean physical component summary (PCS) and mental component summary (MCS) scores were calculated for each injury category and stratified by the presence or absence of probable PTSD and/or depression.

Results

The average follow-up time that participants were surveyed after injury was 10.7 years. Most participants were male, non-Hispanic White, served in the Army, and enlisted rank. Mechanism of injury for 77% was blast-related. Mean PCS and MCS scores across the entire sample were 43.6 (SD = 10.3) and 39.5 (SD = 13.3), respectively; 50% screened positive for depression and/or PTSD. PCS and MCS scores were significantly lower within each injury category among individuals with probable PTSD and/or depression than those without.

Conclusion

Among deployment-injured SMs, those with probable PTSD and/or depression reported significantly lower HRQOL within injury categories and HRQOL component (i.e., physical or mental) than those without. Findings are consistent with prior reports showing mental health symptoms to be strongly associated with lower HRQOL and suggest integration of mental health treatment into standard care practices to improve long-term HRQOL.

vorige artikel A multicenter international prospective study of the validity and reliability of a COVID-19-specific health-related quality of life questionnaire

volgende artikel Assessment of health-related quality of life in Australian patients with idiopathic pulmonary fibrosis: a comparison of the EQ-5D-5L and the AQoL-8D

Alleen toegankelijk voor geautoriseerde gebruikers

Brickell, T. A., Lange, R. T., & French, L. M. (2014). Health-related quality of life within the first 5 years following military-related concurrent mild traumatic brain injury and polytrauma. Military Medicine, 179(8), 827–838. https://doi.org/10.7205/MILMED-D-13-00506CrossRefPubMed

Geraerds, A., Richardson, A., Haagsma, J., Derrett, S., & Polinder, S. (2020). A systematic review of studies measuring health-related quality of life of general injury populations: Update 2010–2018. Health and Quality of Life Outcomes, 18(1), 160. https://doi.org/10.1186/s12955-020-01412-1CrossRefPubMedPubMedCentral

Mazzone, B., Farrokhi, S., Hendershot, B. D., McCabe, C. T., & Watrous, J. R. (2020). Prevalence of low back pain and relationship to mental health symptoms and quality of life after deployment-related lower limb amputation. Spine, 45(19), 1368–1375. https://doi.org/10.1097/BRS.0000000000003525CrossRefPubMed

Mitchell, S. L., Hayda, R., Chen, A. T., Carlini, A. R., Ficke, J. R., MacKenzie, E. J., & METALS Study Group. (2019). The Military Extremity Trauma Amputation/Limb Salvage (METALS) study: Outcomes of amputation compared with limb salvage following major upper extremity trauma. The Journal of Bone and Joint Surgery, 101(16), 1470–1478. https://doi.org/10.2106/JBJS.18.00970CrossRef

Polinder, S., Haagsma, J. A., van Klaveren, D., Steyerberg, E. W., & van Beeck, E. F. (2015). Health-related quality of life after TBI: A systematic review of study design, instruments, measurement properties, and outcome. Population Health Metrics. https://doi.org/10.1186/s12963-015-0037-1CrossRefPubMedPubMedCentral

Watrous, J. R., McCabe, C. T., Jones, G., Farrokhi, S., Mazzone, B., Clouser, M. C., & Galarneau, M. R. (2020). Low back pain, mental health symptoms, and quality of life among injured service members. Health Psychology, 39(7), 549–557. https://doi.org/10.1037/hea0000850CrossRefPubMed

Eskridge, S. L., Macera, C. A., Galarneau, M. R., Holbrook, T. L., Woodruff, S. I., MacGregor, A. J., Morton, D. J., & Shaffer, R. A. (2012). Injuries from combat explosions in Iraq: Injury type, location, and severity. Injury, 43(10), 1678–1682. https://doi.org/10.1016/j.injury.2012.05.027CrossRefPubMed

Stahlman, S., & Taubman, S. B. (2018). Incidence of acute injuries, active component, U.S. Armed Forces, 2008–2017. MSMR, 25(7), 2–9.PubMed

Gill, J., Lee, H., Barr, T., Baxter, T., Heinzelmann, M., Rak, H., & Mysliwiec, V. (2014). Lower health related quality of life in U.S. military personnel is associated with service-related disorders and inflammation. Psychiatry Research, 216(1), 116–122. https://doi.org/10.1016/j.psychres.2014.01.046CrossRefPubMed

10.

MacGregor, A. J., Zouris, J. M., Watrous, J. R., McCabe, C. T., Dougherty, A. L., Galarneau, M. R., & Fraser, J. J. (2020). Multimorbidity and quality of life after blast-related injury among US military personnel: A cluster analysis of retrospective data. BMC Public Health, 20(1), 578. https://doi.org/10.1186/s12889-020-08696-4CrossRefPubMedPubMedCentral

11.

Woodruff, S. I., Galarneau, M. R., McCabe, C. T., Sack, D. I., & Clouser, M. C. (2018). Health-related quality of life among US military personnel injured in combat: Findings from the Wounded Warrior Recovery Project. Quality of Life Research, 27(5), 1393–1402. https://doi.org/10.1007/s11136-018-1806-7CrossRefPubMed

12.

Galarneau, M. R., Hancock, W. C., Konoske, P., Melcer, T., Vickers, R. R., Walker, G. J., & Zouris, J. M. (2006). The Navy-Marine Corps Combat Trauma Registry. Military Medicine, 171(8), 691–697. https://doi.org/10.7205/milmed.171.8.691CrossRefPubMed

13.

Watrous, J. R., Dougherty, A. L., McCabe, C. T., Sack, D. I., & Galarneau, M. R. (2019). The Wounded Warrior Recovery Project: A longitudinal examination of patient-reported outcomes among deployment-injured military personnel. Military Medicine, 184(3–4), 84–89. https://doi.org/10.1093/milmed/usy243CrossRefPubMed

14.

Barell, V., Aharonson-Daniel, L., Fingerhut, L. A., Mackenzie, E. J., Ziv, A., Boyko, V., Abargel, A., Avitzour, M., & Heruti, R. (2002). An introduction to the Barell body region by nature of injury diagnosis matrix. Injury Prevention, 8(2), 91–96. https://doi.org/10.1136/ip.8.2.91CrossRefPubMedPubMedCentral

15.

Association for the Advancement of Automotive Medicine. (2008). Abbreviated Injury Scale 2005: Update 2008 (T. A. Gennarelli & E. Wodzin, Eds.). https://www.nazl.nl/sites/nazl/files/2021-06/AIS0508_codeboek.pdf

16.

The Management and Rehabilitation of Post-Acute Mild Traumatic Brain Injury Work Group. (2021). VA/DoD clinical practice guideline for the management and rehabilitation of post-acute mild traumatic brain injury. Department of Veterans Affairs, Department of Defense. https://www.healthquality.va.gov/guidelines/Rehab/mtbi/VADoDmTBICPGFinal508.pdf

17.

Weathers, F. W., Litz, B. T., Keane, T. M., Palmieri, P. A., Marx, B. P., & Schnurr, P. P. (2013). The PTSD Checklist for DSM-5 (PCL-5). https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp

18.

Blevins, C. A., Weathers, F. W., Davis, M. T., Witte, T. K., & Domino, J. L. (2015). The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): Development and initial psychometric evaluation. Journal of Traumatic Stress, 28(6), 489–498. https://doi.org/10.1002/jts.22059CrossRefPubMed

19.

American Psychiatric Association, American Psychiatric Association DSM-5 Task Force. (2017). Diagnostic and statistical manual of mental disorders: DSM-5. American Psychiatric Association.

20.

Wortmann, J. H., Jordan, A. H., Weathers, F. W., Resick, P. A., Dondanville, K. A., Hall-Clark, B., Foa, E. B., Young-McCaughan, S., Yarvis, J. S., Hembree, E. A., Mintz, J., Peterson, A. L., & Litz, B. T. (2016). Psychometric analysis of the PTSD Checklist-5 (PCL-5) among treatment-seeking military service members. Psychological Assessment, 28(11), 1392–1403. https://doi.org/10.1037/pas0000260CrossRefPubMed

21.

Kroenke, K., Strine, T. W., Spitzer, R. L., Williams, J. B., Berry, J. T., & Mokdad, A. H. (2009). The PHQ-8 as a measure of current depression in the general population. Journal of Affective Disorders, 114(1–3), 163–173. https://doi.org/10.1016/j.jad.2008.06.026CrossRefPubMed

22.

Burg, M. M., Brandt, C., Buta, E., Schwartz, J., Bathulapalli, H., Dziura, J., Edmondson, D. E., & Haskell, S. (2017). Risk for incident hypertension associated with posttraumatic stress disorder in military veterans and the effect of posttraumatic stress disorder treatment. Psychosomatic Medicine, 79(2), 181–188. https://doi.org/10.1097/PSY.0000000000000376CrossRefPubMedPubMedCentral

23.

Haskell, S. G., Ning, Y., Krebs, E., Goulet, J., Mattocks, K., Kerns, R., & Brandt, C. (2012). Prevalence of painful musculoskeletal conditions in female and male veterans in 7 years after return from deployment in Operation Enduring Freedom/Operation Iraqi Freedom. The Clinical Journal of Pain, 28(2), 163–167. https://doi.org/10.1097/AJP.0b013e318223d951CrossRefPubMed

24.

Stewart, I. J., Poltavskiy, E., Howard, J. T., Janak, J. C., Pettey, W., Zarzabal, L. A., Walker, L. E., Beyer, C. A., Sim, A., Suo, Y., Redd, A., Chung, K. K., & Gundlapalli, A. (2021). The enduring health consequences of combat trauma: A legacy of chronic disease. Journal of General Internal Medicine, 36(3), 713–721. https://doi.org/10.1007/s11606-020-06195-1CrossRefPubMed

25.

Ware, J. E., Jr., & Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care, 30(6), 473–483.CrossRefPubMed

26.

Ware, J. E., Kosinski, M. A., & Keller, S. D. (1997). SF-36 physical and mental health summary scales: A user’s manual. Health Assessment Lab, New England Medical Center.

27.

Angkaw, A. C., Haller, M., Pittman, J. O., Nunnink, S. E., Norman, S. B., Lemmer, J. A., McLay, R. N., & Baker, D. G. (2015). Alcohol-related consequences mediating PTSD symptoms and mental health-related quality of life in OEF/OIF combat veterans. Military Medicine, 180(6), 670–675. https://doi.org/10.7205/MILMED-D-14-00473CrossRefPubMed

28.

Jones, D., Kazis, L., Lee, A., Rogers, W., Skinner, K., Cassar, L., Wilson, N., & Hendricks, A. (2001). Health status assessments using the Veterans SF-12 and SF-36: Methods for evaluating outcomes in the Veterans Health Administration. The Journal of Ambulatory Care Management, 24(3), 68–86. https://doi.org/10.1097/00004479-200107000-00011CrossRefPubMed

29.

Seelig, A. D., Jacobson, I. G., Donoho, C. J., Trone, D. W., Crum-Cianflone, N. F., & Balkin, T. J. (2016). Sleep and health resilience metrics in a large military cohort. Sleep, 39(5), 1111–1120. https://doi.org/10.5665/sleep.5766CrossRefPubMedPubMedCentral

30.

McCabe, C. T., Watrous, J. R., Eskridge, S. E., & Galarneau, M. R. (2021). Mclity of life among service members injured on deployment. Health and Quality of Life Outcomes. https://doi.org/10.1186/s12955-021-01852-3CrossRefPubMedPubMedCentral

31.

Copay, A. G., Glassman, S. D., Subach, B. R., Berven, S., Schuler, T. C., & Carreon, L. Y. (2008). Minimum clinically important difference in lumbar spine surgery patients: A choice of methods using the Oswestry Disability Index, Medical Outcomes Study questionnaire Short Form 36, and pain scales. The Spine Journal, 8(6), 968–974. https://doi.org/10.1016/j.spinee.2007.11.006CrossRefPubMed

32.

Neal, C. J., Mandell, K., Tasikas, E., Delaney, J. J., Miller, C. A., Schlaff, C. D., & Rosner, M. K. (2018). Cost-effectiveness of adult spinal deformity surgery in a military healthcare system. Neurosurgical Focus, 45(6), E11. https://doi.org/10.3171/2018.9.FOCUS18381CrossRefPubMed

33.

Badhiwala, J. H., Witiw, C. D., Nassiri, F., Akbar, M. A., Jaja, B., Wilson, J. R., & Fehlings, M. G. (2018). Minimum clinically important difference in SF-36 scores for use in degenerative cervical myelopathy. Spine, 43(21), E1260–E1266. https://doi.org/10.1097/BRS.0000000000002684CrossRefPubMed

34.

Gawande, A. (2004). Casualties of war—Military care for the wounded from Iraq and Afghanistan. The New England Journal of Medicine, 351(24), 2471–2475. https://doi.org/10.1056/NEJMp048317CrossRefPubMed

35.

Howard, J. T., Kotwal, R. S., Stern, C. A., Janak, J. C., Mazuchowski, E. L., Butler, F. K., Stockinger, Z. T., Holcomb, B. R., Bono, R. C., & Smith, D. J. (2019). Use of combat casualty care data to assess the US military trauma system during the Afghanistan and Iraq conflicts, 2001–2017. JAMA Surgery, 154(7), 600–608. https://doi.org/10.1001/jamasurg.2019.0151CrossRefPubMedPubMedCentral

36.

Talbot, L. A., Brede, E., & Metter, E. J. (2017). psychological and physical health in military amputees during rehabilitation: Secondary analysis of a randomized controlled trial. Military Medicine, 182(5), e1619–e1624. https://doi.org/10.7205/MILMED-D-16-00328CrossRefPubMed

37.

Pinheiro, L. C., Wheeler, S. B., Chen, R. C., Mayer, D. K., Lyons, J. C., & Reeve, B. B. (2015). The effects of cancer and racial disparities in health-related quality of life among older Americans: A case–control, population-based study. Cancer, 121(8), 1312–1320. https://doi.org/10.1002/cncr.29205CrossRefPubMed

38.

Shah, A., Ayas, N., Tan, W. C., Malhotra, A., Kimoff, J., Kaminska, M., Aaron, S. D., & Jen, R. (2020). Sleep quality and nocturnal symptoms in a community-based COPD cohort. COPD: Journal of Chronic Obstructive Pulmonary Disease, 17(1), 40–48. https://doi.org/10.1080/15412555.2019.1695247CrossRefPubMed

39.

Pittock, S. J., Mayr, W. T., McClelland, R. L., Jorgensen, N. W., Weigand, S. D., Noseworthy, J. H., & Rodriguez, M. (2004). Quality of life is favorable for most patients with multiple sclerosis: A population-based cohort study. Archives of Neurology, 61(5), 679–686. https://doi.org/10.1001/archneur.61.5.679CrossRefPubMed

40.

Dibble, K. E., Baumgartner, R. N., Boone, S. D., Baumgartner, K. B., & Connor, A. E. (2021). Physical activity, ethnicity, and quality of life among breast cancer survivors and population-based controls: The long-term quality of life follow-up study. Breast Cancer Research and Treatment, 189(1), 247–256. https://doi.org/10.1007/s10549-021-06261-0CrossRefPubMedPubMedCentral

41.

MacGregor, A. J., Dougherty, A. L., McCabe, C. T., & Watrous, J. R. (2021). Trajectory of self-rated health after combat-related injury. Injury, 52(7), 1721–1726. https://doi.org/10.1016/j.injury.2021.04.026CrossRefPubMed

42.

Castillo, D. T., Chee, C. L., Nason, E., Keller, J., C’de Baca, J., Qualls, C., Fallon, S. K., Haaland, K. Y., Miller, M. W., & Keane, T. M. (2016). Group-delivered cognitive/exposure therapy for PTSD in women veterans: A randomized controlled trial. Psychological Trauma: Theory, Research, Practice and Policy, 8(3), 404–412. https://doi.org/10.1037/tra0000111CrossRefPubMed

43.

Rapaport, M. H., Endicott, J., & Clary, C. M. (2002). Posttraumatic stress disorder and quality of life: Results across 64 weeks of sertraline treatment. The Journal of Clinical Psychiatry, 63(1), 59–65. https://doi.org/10.4088/jcp.v63n0112CrossRefPubMed

44.

Benson, C., Singer, D., Carpinella, C. M., Shawi, M., & Alphs, L. (2021). The health-related quality of life, work productivity, healthcare resource utilization, and economic burden associated with levels of suicidal ideation among patients self-reporting moderately severe or sever major depressive disorder in a national survey. Neuropsychiatric Disease and Treatment, 17, 111–123. https://doi.org/10.2147/NDT.S229530CrossRefPubMedPubMedCentral

45.

Grenon, R., Tasca, G. A., Cwinn, E., Coyle, D., Sumner, A., Gick, M., & Bissada, H. (2010). Depressive symptoms are associated with medication use and lower health-related quality of life in overweight women with binge eating disorder. Women’s Health Issues, 20(6), 435–440. https://doi.org/10.1016/j.whi.2010.07.004CrossRefPubMed

46.

Parker, A. M., Sricharoenchai, T., Raparla, S., Schneck, K. W., Bienvenu, O. J., & Needham, D. M. (2015). Posttraumatic stress disorder in critical illness survivors: A metaanalysis. Critical Care Medicine, 43(5), 1121–1129. https://doi.org/10.1097/CCM.0000000000000882CrossRefPubMed

47.

Trivedi, M. H., Rush, A. J., Wisniewski, S. R., Warden, D., McKinney, W., Downing, M., Berman, S. R., Farabaugh, A., Luther, J. F., Nierenberg, A. A., Callan, J. A., & Sackeim, H. A. (2006). Factors associated with health-related quality of life among outpatients with major depressive disorder: A STAR*D report. The Journal of Clinical Psychiatry, 67(2), 185–195. https://doi.org/10.4088/jcp.v67n0203CrossRefPubMed

48.

Zhang, L., Cai, P., & Zhu, W. (2020). Depression has an impact on disease activity and health-related quality of life in rheumatoid arthritis: A systematic review and meta-analysis. International Journal of Rheumatic Diseases, 23(3), 285–293. https://doi.org/10.1111/1756-185X.13774CrossRefPubMed

49.

Goodson, J. T., Lefkowitz, C. M., Helstrom, A. W., & Gawrysiak, M. J. (2013). Outcomes of prolonged exposure therapy for veterans with posttraumatic stress disorder. Journal of Traumatic Stress, 26(4), 419–425. https://doi.org/10.1002/jts.21830CrossRefPubMed

50.

Glassman, L. H., Mackintosh, M. A., Wells, S. Y., Wickramasinghe, I., Walter, K. H., & Morland, L. A. (2020). Predictors of quality of life following cognitive processing therapy among women and men with post-traumatic stress disorder. Military Medicine, 185(5–6), e579–e585. https://doi.org/10.1093/milmed/usz474CrossRefPubMed

51.

Fortin, M., Fortin, C., Savard-Kelly, P., Guay, S., & El-Baalbaki, G. (2021). The effects of psychotherapies for posttraumatic stress disorder on quality of life in the civilian population: A meta-analysis of RCTs. Psychological Trauma: Theory, Research, Practice and Policy. https://doi.org/10.1037/tra0000992CrossRefPubMed

52.

Karlin, B. E., Brown, G. K., Trockel, M., Cunning, D., Zeiss, A. M., & Taylor, C. B. (2012). National dissemination of cognitive behavioral therapy for depression in the Department of Veterans Affairs health care system: Therapist and patient-level outcomes. Journal of Consulting and Clinical Psychology, 80(5), 707–718. https://doi.org/10.1037/a0029328CrossRefPubMed

53.

Possemato, K., Johnson, E. M., Emery, J. B., Wade, M., Acosta, M. C., Marsch, L. A., Rosenblum, A., & Maisto, S. A. (2019). A pilot study comparing peer supported web-based CBT to self-managed web CBT for primary care veterans with PTSD and hazardous alcohol use. Psychiatric Rehabilitation Journal, 42(3), 305–313. https://doi.org/10.1037/prj0000334CrossRefPubMed

54.

McCabe, C. T., Watrous, J. R., & Galarneau, M. R. (2020). Trauma exposure, mental health, and quality of life among injured service members: Moderating effects of perceived support from friends and family. Military Psychology, 32(2), 164–175. https://doi.org/10.1080/08995605.2019.1691406CrossRef

55.

Cigrang, J. A., Rauch, S. A., Mintz, J., Brundige, A. R., Mitchell, J. A., Najera, E., Litz, B. T., Young-McCaughan, S., Roache, J. D., Hembree, E. A., Goodie, J. L., Sonnek, S. M., Peterson, A. L., & STRONG STAR Consortium. (2017). Moving effective treatment for posttraumatic stress disorder to primary care: A randomized controlled trial with active duty military. Families, Systems & Health: The Journal of Collaborative Family Healthcare, 35(4), 450–462. https://doi.org/10.1037/fsh0000315CrossRef

56.

Leung, L. B., Yoon, J., Rubenstein, L. V., Post, E. P., Metzger, M. E., Wells, K. B., Sugar, C. A., & Escarce, J. J. (2018). Changing patterns of mental health care use: The role of integrated mental health services in Veterans Affairs primary care. The Journal of the American Board of Family Medicine, 31(1), 38–48. https://doi.org/10.3122/jabfm.2018.01.170157CrossRefPubMed

Titel: Differences in quality-of-life scores across injury categories by mental health status among injured U.S. military service members and veterans
Auteurs: Judith Harbertson
Andrew J. MacGregor
Cameron T. McCabe
Susan L. Eskridge
Sarah M. Jurick
Jessica R. Watrous
Michael R. Galarneau
Publicatiedatum: 27-10-2022
Uitgeverij: Springer International Publishing
Gepubliceerd in: Quality of Life Research / Uitgave 2/2023
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-022-03263-3

Andere artikelen Uitgave 2/2023

Extending the EQ-5D: the case for a complementary set of 4 psycho-social dimensions

Open Access

Mediating effect of post-stroke depression between activities of daily living and health-related quality of life: meta-analytic structural equation modeling

Review

Effectiveness of a personalized health profile on specificity of self-management goals among people living with HIV in Canada: findings from a blinded pragmatic randomized controlled trial

Significant liver fibrosis is a predictor of poor health-related quality of life in people living with HIV

Open Access

Patient preferences and health state utilities associated with the treatment process of antiretroviral therapy for people living with HIV

Open Access

Health-related quality of life in patients with substance use disorders enrolled to the residential treatment in Sri Lanka: a retrospective cross-sectional study