The underdiagnosis of cannabis use disorders and other Axis-I disorders among military veterans within VHA

Abstract

Recent evidence suggests that rates of cannabis use disorders are significantly lower among military veterans within the Veterans Affairs Health Care System (VA) than the general U.S. population. However, prevalence rates obtained from the VA rely on clinician diagnosis, which have been shown to be underrepresentative of actual disorder rates. The present study utilized structured clinical interviews to assess a sample of 84 military veterans with a cannabis use disorder and compared Axis-I disorder diagnosis rates to those obtained through a retrospective electronic medical record chart review. Findings indicated that cannabis use disorders, as well as posttraumatic stress disorder and other anxiety disorders, were significantly underdiagnosed within this military veteran population. In contrast, rates of other substance use disorders as well as mood disorders were overdiagnosed within this VA population. Findings are discussed in relation to the improvement of screening and repeated structured assessment of military veterans within the VA. © Association of Military Surgeons of the U.S. All rights reserved.