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Holly G. Prigerson, PhD, Paul K. Maciejewski, PhD and Robert A. Rosenheck, MD

Holly G. Prigerson and Robert A. Rosenheck are with the Veterans Affairs Medical Center, West Haven, Conn, and the Department of Psychiatry and Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Conn. Paul K. Maciejewski is with the Donaghue Women's Health Investigator Program, Yale University School of Medicine, New Haven, Conn.

Correspondence: Requests for reprints should be sent to Holly G. Prigerson, PhD, Room 522, Connecticut Mental Health Center, 34 Park St, New Haven, CT 06519 (e-mail: holly.prigerson{at}yale.edu).

Objectives. This study determined the percentage of adverse outcomes in US men attributable to combat exposure.

Methods. Standardized psychiatric interviews (modified Diagnostic Interview Schedule and Composite International Diagnostic Interview assessments) were administered to a representative national sample of 2583 men aged 18 to 54 in the National Comorbidity Survey part II subsample.

Results. Adjusted attributable fraction estimates indicated that the following were significantly attributable to combat exposure: 27.8% of 12-month posttraumatic stress disorder, 7.4% of 12-month major depressive disorder, 8% of 12-month substance abuse disorder, 11.7% of 12-month job loss, 8.9% of current unemployment, 7.8% of current divorce or separation, and 21% of current spouse or partner abuse.

Conclusions. Combat exposure results in substantial morbidity lasting decades and accounts for significant and multifarious forms of dysfunction at the national level.

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