New research shows veterans diagnosed with post-traumatic stress disorder have a higher risk of dying from chronic liver disease, diabetes and viral hepatitis than the general population.

The study, published in the American Journal of Preventive Medicine, was conducted based on the more than 473,800 veterans who initiated PTSD treatment at any Department of Veterans Affairs medical center between fiscal years 2008–13.

PTSD is associated with symptom-related distress, decreased quality of life and higher prevalence for various health conditions resulting from unhealthy lifestyle choices.

The study said patients with PTSD are likely to take part in unhealthy behaviors that increase risk for liver disease. Just over 22% of the study group had alcohol dependence. 

While the study found that this group is at higher risk for death compared with the general population, the risk is smaller than in previous studies. It also found the risk for suicide and unintentional death is high, especially among younger veterans with PTSD. 

According to the study, young veterans with PTSD were more likely to die of unintentional injury and suicide during their first year of treatment, while middle-aged and older veterans were more likely to die of heart disease and cancer.

The connection between age and cause of death among veterans with PTSD isn’t well-known, but “early research suggests that these patients may have accelerated cellular aging”—possibly related to chronic stress over years—and that may put them at increased risk for death, the study said.