Long-Term Consequences of Combat Stress in Afghan War Veterans: Comorbidity of PTSD and Physical and Mental Health Conditions

Ekaterina Ossadchaya, Roza K. Tatayeva, Zhibek Sembayeva, Akmaral Zh. Nursafina, Mira Zhakenova, Gaukhar Slamkhanova

Psychiatry International, 2025

Full text Open access: Gold Metadata (CSL-JSON)
DOI 10.3390/psychiatryint6040141
Data confidence 70 medium
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Abstract

This research represents the first in the Republic of Kazakhstan focusing on Afghan war veterans identified as being at risk for Post-Traumatic Stress Disorder (PTSD). A comprehensive investigation was undertaken regarding the comorbidity of PTSD symptoms, somatic diseases (cardiovascular and others), and mental disorders. The study’s sample comprised 293 Afghan war veterans, while the control group consisted of 149 males without combat experience. The research methodology incorporated data extracted from medical records, a demographic questionnaire, the Mississippi PTSD Scale (military and civilian versions), the Spielberger–Khanin Anxiety Inventory, the Beck Depression Inventory (BDI), and the SCL-90-R questionnaire. Subclinical symptoms indicative of chronic PTSD were identified in 25.2% of veterans, as assessed by the Mississippi PTSD Scale. According to the Spielberger–Khanin questionnaire, veterans with subclinical PTSD exhibited a moderate level of situational (44.96 ± 6.39 points) and personal anxiety (44.14 ± 5.49 points), which were significantly higher than those observed in the control group (29.87 ± 6.50, p2 < 0.001, 36.13 ± 6.82, p2 = 0.003). Furthermore, based on the BDI, these veterans demonstrated an elevated level of depression (13.32 ± 1.36) in comparison to veterans without PTSD (8.61 ± 0.65, p < 0.001) and the control group (4.06 ± 0.75, p < 0.0001). The findings indicate that veterans exhibiting a high level of PTSD are characterized by a more pronounced manifestation of psychopathological indicators, as assessed by the SCL-90-R questionnaire. Compared to the control group, veterans exhibiting PTSD symptoms were found to have a comorbidity with somatic diseases: stage 3 hypertension in 45.2% vs. 21.3% (p2 < 0.001), coronary heart disease in 45.5% vs. 13.4% (p2 < 0.001), and type 2 diabetes mellitus in 20.3% vs. 6.1% (p2 = 0.001). Consequently, Afghan war veterans should be regarded as a high-risk group for cardiovascular diseases (including hypertension and coronary heart disease), cerebrovascular diseases, and mental health disorders. Accordingly, a comprehensive approach is necessary to identify PTSD symptoms alongside concomitant anxiety–depressive disorders and somatic diseases in individuals who have experienced traumatic events.