By Stephen Spotswood
SAN FRANCISCO – One of the most important realizations by VA physician researchers in the past decade has been that mental illnesses such as post-traumatic stress disorder (PTSD) and depression can be linked, sometimes very strongly, to various physical illnesses. The tally of those physical ailments is rising, and researchers continue to find surprising links.
One connection that might not occur to physicians treating recently returned veterans, and for which evidence is accumulating rapidly, is between mental illness and lower urinary tract symptoms (LUTS). These include problems with urinary frequency, urgency and nocturnal urination, which are relatively common in older men.
The medical literature suggests, however, that these symptoms can occur in younger people, particularly when there’s a corresponding mental illness.
An examination of existing data on VA patients reinforced this, suggesting a strong corollary between Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans with PTSD and depression and these symptoms. The study results have encouraged researchers to look more closely at the link, and ways in which military service can lead to LUT dysfunction.
This research is being led by Benjamin Breyer, MD, a urologic surgeon at the University of California, San Francisco Medical Center and Karen Seal, MD, a staff physician at the San Francisco VAMC and codirector of the facility’s OEF/OIF Integrated Care Clinic, which provides one-stop primary care, mental health and social services to returning veterans.
When the two physician-researchers teamed up several years ago, they came at the issue from very different vantage points — Seal from a history of research into veterans with PTSD, Brayer from that of a surgeon focusing on one specific area of health. Both were seeing the same phenomenon: younger patients, especially those with mental-health issues, complaining of LUTS.