@article{ref1,
title="Grief and physical health outcomes in U.S. soldiers returning from combat",
journal="Journal of affective disorders",
year="2011",
author="Toblin, Robin L. and Riviere, Lyndon A. and Thomas, Jeffrey L. and Adler, Amy B. and Kok, Brian C. and Hoge, Charles W.",
volume="136",
number="3",
pages="469-475",
abstract="BACKGROUND: Few studies have measured the burden of physical health problems after Iraq/Afghanistan deployment, except in association with post-traumatic stress disorder (PTSD) or mild traumatic brain injury (mTBI). Grief, a correlate of health problems in the general population, has not been systematically examined. We aimed to identify the prevalence of post-deployment physical health problems and their association with difficulty coping with grief. METHODS: Infantry soldiers (n=1522) completed anonymous surveys using validated instruments six months following deployment in November-December 2008. Multiple logistic regression was used to assess the association of difficulty coping with grief and physical health. RESULTS: The most frequent physical health symptoms reported were: sleep problems (32.8%), musculoskeletal pain (32.7%), fatigue (32.3%), and back pain (28.1%). Difficulty coping with grief over the death of someone close affected 21.3%. There was a dose-response relationship between level of difficulty coping with grief and principal physical health outcomes (ps<.002). Controlling for demographics, combat experiences, injuries, PTSD, depression, and other factors, grief significantly and uniquely contributed to a high somatic symptom score (adjusted odds ratio (AOR)=3.6), poor general health (AOR=2.0), missed work (AOR=1.7), medical utilization (AOR=1.5), difficulty carrying a heavy load (AOR=1.7), and difficulty performing physical training (AOR=1.6; all 95% confidence intervals >1). LIMITATIONS: Data are cross-sectional and grief was measured with one item. CONCLUSIONS: Over 20% of soldiers reported difficulty coping with grief. This difficulty was significantly associated with physical health outcomes and occupational impairment. Clinicians should be aware of the unique role grief plays in post-deployment physical health when treating patients.<p /> <p>Language: en</p>",
language="en",
issn="0165-0327",
doi="10.1016/j.jad.2011.10.048",
url="http://dx.doi.org/10.1016/j.jad.2011.10.048"
}