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Publication Briefs

Study Shows High Economic Burden of PTSD

PTSD is associated with an increased risk of substance use disorder, disability, unemployment, and premature mortality, all of which contribute to a substantial clinical burden. PTSD also is associated with a substantial economic burden. However, there is limited literature describing the total economic burden of PTSD in the United States. Most studies focus on the military population and/or are limited to direct healthcare costs. Therefore, this study sought to estimate the economic burden of PTSD in the U.S. civilian and military (i.e., military and Veterans) populations from a societal perspective. Investigators used insurance claims data, academic literature, and governmental publications to estimate the total excess costs of PTSD in 2018. They assessed direct healthcare costs (pharmacy and medical), direct non-healthcare costs (research, substance use, homelessness, disability, psychotherapy), and indirect costs (unemployment, productivity loss, caregiving, premature mortality). Each cost component was estimated using a prevalence-based approach. Using data from the Census Bureau, VA, and the DoD, investigators estimated that 2,607,131 male and 7,558,833 female adult civilians in the U.S. have PTSD, as well as 1,368,925 males and 293,256 females in the U.S. military/Veteran population.


  • The economic burden of PTSD goes beyond direct healthcare costs and has been found to rival costs for other expensive mental health conditions. The total excess economic burden of PTSD in the US was estimated at $232 billion for 2018 ($19,630 per individual with PTSD).
  • A larger proportion of total excess costs was attributed to the civilian population ($190 billion, or 82%) than the military/Veteran population ($43 billion, or 18%). However, excess costs per individual with PTSD are lower for the civilian population ($18,640) than the military/Veteran population ($25,684).
  • In the military/Veteran population, excess burden was driven by disability ($18 billion) and direct healthcare ($10 billion) costs.
  • In the military/Veteran population, the annual all-cause mortality rate for those with PTSD was estimated to be 80% higher than those without PTSD, resulting in estimated excess costs of $1 billion annually.


  • Findings warrant an increased awareness of PTSD and expansion of evidence-based interventions.


  • For direct healthcare costs, individuals were identified based on a documented diagnosis of PTSD, which might omit those who were undiagnosed. Further, reliance on ICD codes to identify patients with PTSD may have resulted in misclassification.
  • Some cost components might have been overestimated; for example, residual costs associated with the trauma (i.e., medical costs to treat an injury) may have been captured.

Dr. Davis is an HSR&D affiliate investigator and is part of the Tuscaloosa VA Medical Center, Tuscaloosa, AL.

Davis L, Schein J, Cloutier M, et al. The Economic Burden of Post-traumatic Stress Disorder in the United States from a Societal Perspective. Journal of Clinical Psychiatry. April 25, 2022;83(3):21m14116.

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What are HSR Publication Briefs?

HSR requires notification by HSR-funded investigators about all articles accepted for publication. These journal articles are reviewed by HSR and publication briefs or summaries are written for a select number of articles that are then forwarded to VHA Central Office leadership to keep them informed about important findings or information. Articles to be summarized are selected by HSR based on timeliness of the findings, interest of leadership, or potential impact on the organization. Publication briefs are written for only a small number of HSR published articles. Visit the HSR citations database for a complete listing of HSR articles and presentations.

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