The association between substance use disorders and mortality among a cohort of Veterans with posttraumatic stress disorder: Variation by age cohort and mortality type

BACKGROUND: Prior studies of Veterans have linked posttraumatic stress disorder (PTSD) with an increased risk of mortality. Other studies of Veterans have found that substance use disorders (SUDs) are associated with an excess risk of mortality among those with psychiatric disorders. It is not known whether having an SUD increases the risk of mortality among Veterans with PTSD, and whether the association differs by mortality type or varies by age cohort. METHODS: A cohort of patients who received Veterans Health Administration services during fiscal year (FY) 2004 and diagnosed with PTSD (n=272,509) were followed from FY 2005 through FY 2007 for the main outcomes of mortality and cause of death. RESULTS: SUD was positively associated with mortality during follow-up (adjusted hazards ratio: 1.70; 95% confidence interval: 1.64, 1.77). SUD was a stronger predictor of non-injury-related mortality for the Language: en