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Cohort study reveals a 20-percent excess mortality in veterans discharged for psychoneurosis, indicating behavioral factors rather than chronic physical dysfunction drive the risk.
World War II Army inductees medically discharged for psychoneurosis in 1944 experienced a 20-percent excess mortality over the period 1946-1969, highest in the earlier years and diminishing thereafter. Some of the differential mortality, e.g., from inflammatory diseases of the CNS, may represent diagnostic error in 1944. Behavioral maladjustments, or pathological personality types coexisting with psychoneurosis, may explain the increased risk of death from alcoholism, suicide, and homicide. Although they usually existed prior to service, and most probably continued thereafter, the anxiety and emotional conflicts leading to discharge in 1944 seem not to have been associated with chronic disturbances of physiologic function sufficient to cause severe organic disease in later life. A possible exception is cerebrovascular disease, for which the discrepancy is neither large nor reinforced by similar differences in mortality from hypertension or hypertensive heart disease.
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Keehn et al. (1974) studied this question.
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