Is Acute Stress Reaction a Risk Factor for Early Mortality?

This study aimed to examine the role of combat stress reaction (CSR) in predicting all-cause mortality over a 33-year period following the end of the war. Method: Two groups of male veterans from the 1982 Lebanon War participated in this study in 1983 (T1) and 2016 (T2): the CSR group (n 375) and a matched comparison group (n 305) consisting of combatants who had participated in combat in the same units as the CSR group but were not identified as having CSR. Participants were assessed for posttraumatic stress disorder symptoms and depressive symptoms in T1 and mortality in T2. Results: The distribution of mortality rates was significantly different between the 2 groups and higher among the CSR group (n 32, 8.5%) as compared to the comparison group (n 12, 3.9%; 2 5.89, p .01). Both posttraumatic stress disorder symptoms and depressive symptoms were controlled for because they have been shown to be risk factors for all-cause mortality. The mortality curve of the CSR group increased steeply around the age of 40 years, whereas in the comparison group, the increase was less substantial. Conclusions: CSR was found to be a significant predictor of all-cause mortality. The risk for mortality was higher and earlier among the CSR group compared with the comparison group. The findings of this study call attention to the importance of immediately identifying CSR to better care for the individual and minimize long-term negative effects.