Abstract
Objective
Individuals with mental health problems are at elevated risk for eating disorders.
Veterans serving in support of the conflicts in Afghanistan and Iraq (OEF/OIF) have
a high prevalence of deployment-related mental health problems, but little is known
about their risk for eating disorders. Our aim was to determine rates of eating disorder
diagnoses among OEF/OIF veterans with mental health problems, particularly among those
with comorbid mental health problems.
Methods
This retrospective, cross-sectional analysis of nationwide VA healthcare facilities
used descriptive statistics and regression analyses to determine eating disorder rates
in OEF/OIF veterans who were new users of VA healthcare from October 7, 2001 to December
31, 2010 (N = 593,739).
Results
Although the prevalence of eating disorder diagnoses was 0.007% (n = 465) in women and <0.001% (n = 192) in men, veterans diagnosed with mental health problems were significantly
more likely to have an eating disorder than those without mental health diagnoses.
Eating disorders were significantly more common in women with depression, posttraumatic
stress disorder, and alcohol and/or drug use disorders than in women veterans without
these mental health disorders. Among men, the associations between eating disorder
diagnoses and comorbid mental health diagnoses closely paralleled those observed in
women.
Conclusions
Rates of eating disorders are significantly higher among returning veterans with comorbid
mental health problems compared with those without mental health diagnoses. Further
research should examine methods to improve detection and treatment of eating disorders
in this population.
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References
- Mortality rates in patients with anorexia nervosa and other eating disorders: A meta-analysis of 36 studies.Archives of General Psychiatry. 2011; 68: 724-731
- The economic and social burden of eating disorders.in: Maj M. Halmi K. Lopez-Ibor J.J. Sartorius N. Eating disorders. Wiley, New York2003: 383-396
- Suicidality in eating disorders: Occurrence, correlates, and clinical implications.Clinical Psychological Review. 2006; 26: 769-782
- Sourcebook: Women veterans in the Veterans Health Administration. Volume 1. Sociodemographic characteristics and use of VHA care.Women's Health Evaluation Initiative, Women Veterans Health Strategic Health Care Group, Veterans Health Administration, Department of Veterans Affairs, Washington, DC2010
- The comorbidity of substance use disorders and eating disorders in women: Prevalence, etiology, and treatment.Addictive Behaviors. 2010; 35: 392-398
- Review of the prevalence and incidence of eating disorders.Internal Journal of Eating Disorders. 2003; 34: 383-396
- The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication.Biological Psychiatry. 2007; 61: 348-358
- Disordered eating and weight changes after deployment: Longitudinal assessment of a large US military cohort.American Journal of Epidemiology. 2009; 69: 415-427
- Gender differences in mental health diagnoses among Iraq and Afghanistan veterans enrolled in VA healthcare.American Journal of Public Health. 2010; 100: 2450-2456
- Prevalence and contributing factors of eating disorder behaviors in active duty Navy men.Military Medicine. 1997; 162: 753-758
- Prevalence and contributing factors of eating disorder behaviors in active duty service women in the Army, Navy, Air Force, and Marines.Military Medicine. 2001; 166: 53-58
- Eating disorders and comorbidity.Archives of Women's Mental Health. 2002; 4: 67-78
- Posttraumatic stress disorder in anorexia nervosa.Psychosomatic Medicine. 2011; 73: 491-497
- Bringing the war back home: Mental health disorders among 103,788 US veterans returning from Iraq and Afghanistan seen at Department of Veterans Affairs facilities.Archives of Internal Medicine. 2007; 167: 476-482
- The health service use and cost of eating disorders.Psychological Medicine. 2005; 35: 1543-1551
- Eating disorders in a national sample of hospitalized female and male veterans: Detection rates and psychiatric comorbidity.International Journal of Eating Disorders. 1999; 25: 405-414
- One-year use and cost of inpatient and outpatient services among female and male patients with an eating disorder: evidence from a national database of health insurance claims.International Journal of Eating Disorders. 2000; 27: 381-389
- Disordered eating in entry-level military personnel.Military Medicine. 2007; 172: 147-151
- Emotion avoidance in patients with anorexia nervosa: initial test of a functional model.International Journal of Eating Disorders. 2010; 43: 398-404
Biography
Shira Maguen is a Research Psychologist at the San Francisco VA Medical Center and Assistant Professor in the Department of Psychiatry at the University of California, San Francisco. She specializes in PTSD research, with an interest in women veterans' mental health.
Biography
Beth Cohen is a Staff Physician at the San Francisco VA Medical Center and Assistant Professor in the Department of Medicine at the University of California, San Francisco. Her research focuses on the effects of PTSD on physical health.
Biography
Greg Cohen was a Research Associate at the San Francisco VA Medical Center. He is now at the Mailman School of Public Health at Columbia University.
Biography
Erin Madden is a Data Analyst at the San Francisco VA Medical Center with an expertise in quantitative methods and analysis.
Biography
Daniel Bertenthal is a Data Analyst at the Mental Illness Research, Education, and Clinical Center at the San Francisco VA Medical Center.
Biography
Karen Seal is an Associate Professor of Medicine and Psychiatry at the University of California, San Francisco. As Co-Director of the Iraq/Afghanistan Veteran Integrated Care Clinic at the San Francisco VA Medical Center, she investigates primary care-mental health integration.
Article info
Publication history
Accepted:
April 20,
2012
Received in revised form:
February 21,
2012
Received:
October 29,
2011
Footnotes
Supported by Department of Defense Concept Award Grant (Maguen), VA Health Sciences Research and Development (HSR&D) Career Development Award (Maguen), and National Institutes of Health grant K23 HL 094765-01 (Cohen).
Identification
Copyright
Published by Elsevier Inc.
