2015. Psychiatric and Medical Conditions Associated with Quality of Life among Veterans with Chronic Posttraumatic Stress Disorder (PTSD)
JL Strauss, Durham VAMC, Duke Medical Center, PS Calhoun, Durham VAMC, Duke Medical Center, ME Feldman, Durham VAMC, JC Beckham, Durham VAMC, Duke Medical Center

Objectives: It has been proposed that clinicians look beyond symptom severity and consider patient quality of life in case conceptualization, treatment planning, and the comprehensive assessment of treatment progress. However, the distinction between quality of life and mental health pathology remains unclear. The relationship between quality of life and symptom severity among veterans with posttraumatic stress disorder (PTSD), who often experience chronic symptoms and require long-term treatment, has not yet been explored. This study was designed to examine the unique relationship between quality of life, PTSD symptom severity, and comorbid psychiatric and medical conditions.

Methods: Data were collected on a sample of male veterans (N = 261) diagnosed with chronic PTSD at a VAMC specialty clinic.  Participants total Davidson Trauma Scale scores determined PTSD symptom severity, quality of life was determined by Quality of Life Inventory total scores.  We first examined bivariate associations between veterans’ self-reported quality of life and patient demographic characteristics and common clinical correlates including: presence of major depression, alcohol abuse, drug use, physical violence, medical morbidity, and current life stressors. Factors significant in bivariate analyses and participants’ PTSD severity scores were entered into a multivariate model, examining overall quality of life.

Results: In the adjusted model, age (Beta = .13, p = .03), medical morbidity (Beta = -.15, p = .02), current life stressors (Beta  = -.32, p =<.001), and PTSD symptom severity (Beta = -.14, p = .03 were significantly related with quality of life.

Conclusions: Quality of life among veterans with PTSD is associated with age and with the presence of medical morbidity and life stressors, in addition to PTSD symptom severity.

Impact: Quality of life among PTSD patients is not simply a proxy for disease severity. To maximize quality of life among veterans with PTSD, clinicians’ case conceptualization and treatment plans should incorporate the role of comorbid medical and life difficulties.  Interventions to bolster veterans’ self-care and coping skills may be useful adjuncts to traditional PTSD therapies. As many veterans with PTSD suffer chronic psychiatric difficulties,  interventions to improve these veterans’ quality of life merit a vital role in treatment planning.