Posttraumatic stress disorder or depression affects between 8.5% and 14% of soldiers returning from Iraq, says a report published in Archives of Psychiatry, a JAMA/Archives journal – causing serious functional impairment.
As background information in the article, the authors write:
A growing body of literature has demonstrated the association of combat in Iraq and Afghanistan with post-deployment mental health problems, particularly posttraumatic stress disorder (PTSD) and depression. However, studies have shown varying prevalence rates of these disorders based on different case definitions and have not assessed functional impairment, alcohol misuse or aggressive behavior as comorbid factors occurring with PTSD and depression.
Between 2004 and 2007, Jeffrey L. Thomas, Ph.D., of the Walter Reed Army Institute of Research, Silver Spring, Md., and team collected anonymous mental health surveys of 18,305 U.S. Army soldiers, 3 and 12 months after deployment. The soldiers were members of four Active Component (non-reserve) and two National Guard (reserve) infantry brigade combat teams. They were tested for PTSD, depression, alcohol misuse and aggressive behaviors, and asked if these problems caused difficulties at work, at home, or socially.
The authors explained:
Using the least stringent definition, we observed PTSD rates across Active Component and National Guard study groups, study time points ranging from 20.7 percent to 30.5 percent, and depression rates ranging from 11.5 percent to 16 percent. Using the strictest definitions with high symptom rates and serious functional impairment, PTSD prevalence ranged from 5.6 percent to 11.3 percent and depression prevalence from 5 percent to 8.5 percent.
Alcohol misuse or aggressive behavior – including slamming a door, punching a wall or threatening or perpetrating physical violence in anger – was prevalent in approximately 50% of the cases of PTSD or depression.
Between the 3- and 12-month time points, depression and/or PTSD rates stayed the same among Active Component soldiers but grew among National Guard soldiers, even though they had similar rates of combat experiences and similar prevalence rates of mental health problems three months after deployment.
The authors wrote:
Therefore, the emergence of differences by 12 months likely does not have to do with differences in the health effects of combat but rather with other variables related to readjustment to civilian life or access to health care.
The results indicate consequences not only for the care of returning soldiers and their families, but also peers in their units, the authors conclude.
The findings of the study show that at 12 months following combat, the prevalence of mental health problems among veterans does not abate, and in many cases, increases. It is a virtual certainty that soldiers who remain in service will deploy again; this study shows that a sizable proportion (9% to 14%) have depression or PTSD symptoms with serious functional impairment. If soldiers who are struggling with serious functional impairment as the result of a previous deployment are deployed again, there is potential that this could impair their performance in combat. This has implications for the safety of unit members and mission success.
Jeffrey L. Thomas, PhD; Joshua E. Wilk, PhD; Lyndon A. Riviere, PhD; Dennis McGurk, PhD; Carl A. Castro, PhD; Charles W. Hoge, MD
Arch Gen Psychiatry. 2010;67(6):614-623.
Written by Christian Nordqvist