The Health of Former Prisoners of War Results from the Medical Examination Survey of Former POWs of World War II and the Korean Conflict (1992) / Chapter Skim
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6 Further Analyses of Examination Data
6 Further Analyses of Examination Data
Pages 71-84
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From page 71... ...
Aside from the difficulties caused by low response rates, the chief problem in Chapter 5 was the lack of definite, specific hypotheses about medical conditions, a lack easily seen when such conditions were contrasted with mental disorders. As explained earlier, similar research on former Australian prisoners of the Japanese, conducted on an admittedly smaller scale, found no excess prevalence of medical conditions among former POWs except for ulcer specifically, a history of and not current ulcers- and increased use of analgesics, suggesting an increased prevalence of arthritis that was, however, not directly observable.
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From page 72... ...
There were additional International Classification of Diseases rubrics with higher POW current prevalence rates as well, but in almost all of those cases, a specific disease had already been singled out for analysis for example, ulcer in the digestive disease group and peripheral nerve disease in the nervous system group. The apparent deficit of other endocrine disease among POOP, which was primarily due to an excess number of WP cases of other metabolic and immunity disorders, is not analyzed further, given the earlier data on the possible nonrepresentativeness of the WP group and the failure of other control groups to show this excess.
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From page 73... ...
Among the medical conditions, there are appreciably higher prevalence rates of ischemic heart disease for PWEM, peripheral nerve disease for PWP and PWK, and gastroenteritis for PWEM and PWK;
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From page 74... ...
Comparing POWs with themselves, using those less harshly treated as a basis for comparison with those more harshly treated, should not only provide a more sensitive analysis but should also avoid the problems that arise from analyzing data from a small and potentially unrepresentative control group, such as the WP. This chapter continues with a set of analyses that use POWs as internal controls to provide independent information about possible associations between selected medical conditions and prior military captivity.
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From page 75... ...
Later in this chapter, these prison camp symptoms will be aggregated into three separate measures, two of which edema and visual symptoms (such as night blindness) have obvious associations with specific nutritional deprivations (thiamin and vitamin A, respectively)
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From page 76... ...
The data in Table 6.3 show a number of noteworthy differences in prevalence rates between low- and high-weight-loss groups, including intermittent claudication, arterial vascular disease, peripheral nerve disease, and osteoarthritis. In the light of the findings discussed in earlier chapters, this appreciable association of weight loss and intermittent claudication and peripheral nerve disease is probably not surprising, nor are the appreciably higher rates of depressive disorder and PTSD among the high-weight-loss group; Eberly and Engdahl's study showed significant associations with depression, schizophrenia, PTSD, and generalized anxiety disorder.
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From page 77... ...
(N=287) Medical conditions Hypertension 43.4 43.6 Diabetes mellitus 11.4 14.6 Anemia 5.3 5.6 Cerebrovascular disease 1.4 1.7 Ischem~c heart disease 19.6 21.3 Myocardial infarction 0.7 1.1 Intermittent claudication 10.3 17.4a Arterial vascular disease 21.0 31.4a Asthma 5.0 5.9 COPD 12.5 17.1 Peripheral nerve disease 10.7 19.2a Deafness 48.8 55.8 Ulcer 15.0 17.8 Gastroententis 15.7 20.6 Osteoarthritis 34.9 25.8a Traumatic arthritis 0.7 1.4 Psychiatric conditions Depressive disorder 40.2 53.7a Alcohol abuse or dependence 19.6 19.9 Schizophrenia 3.2 2.1 PTSD 29.2 41.Sa Generalized anxiety 44.5 51.2 COPD, chronic obstructive pulmonary disease; PTSD, posttraumatic stress disorder.
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From page 78... ...
(N=185) Medical conditions Hypertension 44.9 42.5 43.2 Diabetes mellitus 14.6 9.6 14.6 Anemia 6.7 5.8 4.3 Cerebrovascular disease 0.6 2.9 0.5 Ischem~c heart disease 15.8 19.6 23.8 Myocardial infarction 0.6 0.0 2.2 Intermittent claudication 9.1 13.8 18.4a Artenal vascular disease 22.4 24.2 31.9a Asthma 3.0 5.0 8.1a COPD 12.1 13.8 17.3 Peripheral nerve disease 9.7 12.9 21.1a Deafness 49.1 54.6 50.8 Ulcer 10.3 22.1 14.1 Gastroententis 14.6 17.1 20.5 Osteoarthritis 33.9 30.8 24.9 Traumatic arthritis 1.2 0.0 2.2 Psychiatric conditions Depressive disorder 32.7 44.6 61.1a Alcohol abuse or dependence 15.8 22.9 18.9 Schizophrenia 0.6 2.5 4.3a PTSD 23.0 38.8 40.oa Generalized anxiety 40.0 48.3 S2.4a COPD, chronic obstructive pulmonary disease; PTSD, posttraumatic stress disorder.
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From page 79... ...
Many of the appreciable correlations in Table 6.5 reflect earlier noteworthy differences in the combined POW data in Tables 6.3 and 6.4. The noteworthy association of prison camp symptoms with peripheral nerve disease, for example, is seen in both PWP and PWE, and all three groups show appreciable correlations of prison camp symptoms with depressive disorder.
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From page 80... ...
N.a. PTSD .079 -.004 .122a .113 .024 .139 Generalized anxiety .279a .144a .073 -.014 -.018 -.019 POOP, prisoner of war, Pacific theater, WW II; PWK, prisoner of war, Korean conflict; PWE, prisoner of war, European theater, WW II; COPD, chronic obstructive pulmonary disease; PTSD, posttraumatic stress disorder; N.a., not applicable.
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From page 81... ...
The data for symptom scores show noteworthy associations with ischemic heart disease, ulcer, asthma, depressive disorder, and generalized anxiety, as well as somewhat weaker associations with PTSD and cerebrovascular disease. That there are a number of common medical conditions among different analyses is a comforting finding; it suggests that the analyses undertaken thus far in this chapter have unearthed a number of strong candidates for current medical conditions that might be associated with earlier military captivity.
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From page 82... ...
, and the remaining 13 symptoms were added together for a third symptom marker. These three symptom markers plus percent weight loss and POW group were used as independent variables in logistic regression analyses of the medical conditions reported in Table 6.6, plus schizophrenia (from Tables 6.4 and 6.5)
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From page 83... ...
PWK 2.144 (1.517-3.030) PWK, prisoner of war, Korean conflict; POOP, prisoner of war, Pacific theater, WW II; PWE, prisoner of war, European theater, WW II; WP, war veteran, Pacific theater, WW II.
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From page 84... ...
To summarize, this chapter's analyses were directed at more specific medical conditions and, using POWs as internal controls, have suggested a number of new findings. Appreciably higher prevalences of current ischemic heart disease, intermittent claudication, arterial vascular disease, peripheral nerve disease, ulcer, and asthma appear to be associated with nutritional deprivation and other measures of treatment during imprisonment; there are less strong associations of these factors with current prevalence of gastroenteritis as well as an apparently lower prevalence of osteoarthritis in those with higher weight loss.
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