Dartmouth Medical School, 2 Whipple Place Suite 202, Lebanon, NH 03766, USA.
Psychosomatics. 2010 Nov-Dec;51(6):503-7. doi: 10.1176/appi.psy.51.6.503.
Soldiers often return from war with a variety of combat-related mental health conditions, including posttraumatic stress disorder, depression, and substance-use disorders.
The authors investigated common co-occurring medical and psychiatric conditions and patterns of conditions among returning Iraq/Afghanistan veterans using the Veterans Administration (VA) healthcare systems.
Common clusters of ICD-9 diagnostic-related conditions among returning soldiers (N=293,861) were extracted from the VA data center.
Diagnoses involving pain are extremely common among returning veterans seeking health care at the VA. In addition to pain-related conditions, psychiatric disorders rank second most prevalent. Psychiatric disorders, and in particular the multimorbid triad of pain, posttraumatic stress disorder, and depression frequently overlap.
As more veterans return from war, there will be greater need for effective services. Given the findings of high rates of comorbidity and multimorbidity, VA services should be reorganized so as to co-locate psychiatric staff in pain centers, simultaneously targeting pain and psychiatric disorders.
士兵在战后常常会出现各种与战斗相关的心理健康问题，包括创伤后应激障碍、抑郁和物质使用障碍。
作者利用退伍军人事务部（VA）的医疗保健系统，调查了返回的伊拉克/阿富汗退伍军人中常见的共病医疗和精神疾病状况及疾病模式。
从 VA 数据中心提取了 293861 名返回士兵的 ICD-9 诊断相关疾病的常见聚类。
在退伍军人事务部寻求医疗的退伍军人中，与疼痛相关的诊断极其常见。除了与疼痛相关的疾病外，精神疾病的发病率位居第二。精神疾病，特别是疼痛、创伤后应激障碍和抑郁的多态三联征，经常重叠。
随着越来越多的退伍军人从战争中归来，对有效服务的需求将会增加。鉴于共病和多态性的高发生率，退伍军人事务部的服务应该重新组织，以便将精神科工作人员安置在疼痛中心，同时针对疼痛和精神疾病。
