Comparative Analysis of the Relationship Between PTSD and Somatic Complaints According to the Mediation Model in Post-Deployment and COVID-19 Cohorts in Georgia

Background: Several studies have shown a link between PTSD, somatic symptoms (physical complaints without a clear medical cause), and the mediating effects of depression and anxiety. This study builds upon this knowledge by examining how two distinct stressful experiences - combat deployment in veterans with PTSD and COVID-19 diagnosis - influence somatic complaints through underlying depression and anxiety symptoms. Methods: The study involved two groups: Group 1: 2,799 veterans assessed after a 6-month deployment using the PTSD Checklist (PCL-5) and Patient Health Questionnaire (PHQ) for depression, anxiety, and somatic complaints. Group 2: 83 patients diagnosed with COVID-19, assessed one month after discharge using the same tools (PCL-5 and PHQ). Both groups employed mediation analysis to investigate the indirect effect of stressful experiences (PTSD for veterans and COVID-19 for patients) on somatic complaints mediated by depression and anxiety. Results: Both veteran and COVID-19 patient groups displayed a significant indirect effect of the stressful event on somatic complaints mediated by depression and anxiety. In veterans, the effect size was 0.14 (95% CI [0.12, 0.16]), while for COVID-19 patients, it was 0.16 (95% CI [0.08, 0.26]). Additionally, the study found a high prevalence of depression, anxiety, and somatic complaints in the COVID-19 patient group. Combining these findings is crucial for a more comprehensive understanding of how stressful experiences, regardless of origin, can manifest in physical symptoms through the pathway of depression and anxiety. This combined analysis strengthens the evidence for the mediating role of these mental health conditions. It underscores the importance of addressing them in treatment plans for patients with stress-related disorders, including both veterans with PTSD and those experiencing the mental health effects of COVID-19. This research has significant implications for developing more holistic treatment approaches that integrate mental health interventions alongside the management of physical symptoms. The findings can inform healthcare professionals in various settings to better identify and address the complex interplay between stressful experiences, mental health, and physical well-being. These findings align with NATO’s emphasis on integrated, cross-national approaches to mental and physical health, supporting interoperable strategies for operational readiness.