Iraq Veterans Experience Delayed Mental Stress, Study Finds

Main Category: Veterans / Ex-Servicemen
Also Included In: Psychology / Psychiatry;  Anxiety / Stress
Article Date: 15 Nov 2007 - 8:00 PDT

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Soldiers who served in Iraq are experiencing much greater mental distress three to six months after leaving the war zone than when they first returned to the U.S., according to a Walter Reed Army Institute of Research/U.S. Army Center for Health Promotion and Preventive Medicine study published in the Journal of the American Medical Association, the Washington Post reports. For the study, researchers analyzed questionnaires completed by 88,235 Iraq War soldiers. About 56,000 of the respondents remain on active duty, while 32,000 are in the Army Reserve or National Guard. Ninety percent of the questionnaires were completed by men, 60% of whom were married (Scott Tyson, Washington Post, 11/14).

Overall, almost one-third of the servicemembers had signs of depression, post-traumatic stress disorder, conflicts in relationships and other mental health problems six months after leaving Iraq, the study found (Johnson, AP/Long Island Newsday, 11/13). According to the study, soldiers were far more likely to report problems such as PTSD and conflicts with family or friends during a screening performed three to six months after returning from Iraq compared with an assessment taken immediately upon their return (Washington Post, 11/14).

Paul Reickhoff, executive director of Iraq and Afghanistan Veterans of America, said that in the initial screening, soldiers might have minimized concerns so they would not be delayed in returning home. In addition, there is a "honeymoon period" upon returning home that lasts until negative experiences begin to sink in, according to the Los Angeles Times (Maugh, Los Angeles Times, 11/13). Stephen Jones, an Army assistant surgeon general, said, "When you come back, ... you're almost euphoric, ... you don't have any problems in the world," but after some time has passed, "the stress starts to resurface."

Problems Reported More Among Reservists Than Active Duty
The study also found National Guard members and reservists reported mental health problems at higher rates than active-duty troops. Based on the two screenings -- one occurring immediately upon return and one occurring up to six months later -- one in five active-duty Army soldiers and more than 40% of Army reservists were identified as being in need of treatment for their mental distress. During the second screening, 24.5% of reservists reported concerns with PTSD, compared with 16.7% of active-duty soldiers; 13% of reservists reported depression concerns, compared with 10.3% of active servicemembers; and 35.5% of reservists were concerned about their risk of developing mental health problems, compared with 27.1% of active-duty soldiers.

In addition, nearly 12% of active-duty soldiers and 15% of reservists reported abusing alcohol, yet less than 1% were referred for substance-abuse treatment, possibly due to concerns about treatment records not being confidential, according to the study. According to the Post, reservists might experience more mental health problems because of the adjustment to civilian life without the daily support of their "war-zone comrades" (Washington Post, 11/14). In addition, Reickhoff said, reservists and National Guard members might be more willing to admit to mental health problems than active-duty military members because of perceived stigma (Los Angeles Times, 11/14).

Recommendations
Researchers recommended that the Army provide mental health care services to veterans and their family members "before symptoms become chronically entrenched" (Washington Post, 11/14). Treating mental illness early can help prevent long-term problems, according to lead researcher Charles Milliken of Walter Reed (Los Angeles Times, 11/13).

However, the study also questions the effectiveness of PTSD treatment in the "overburdened" military medical system, finding "no direct relationship of referral or treatment with symptom improvement" (Washington Post, 11/14).

The study is available online

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