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Prevalence of mental health problems and functional impairment among active component and National Guard soldiers 3 and 12 months following combat in Iraq.
Arch Gen Psychiatry. 2010 Jun; 67(6):614-23.AG

Abstract

CONTEXT

A growing body of literature has demonstrated the association of combat in Iraq and Afghanistan with postdeployment 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.

OBJECTIVES

To (1) examine the prevalence rates of depression and PTSD using several case definitions including functional impairment, (2) determine the comorbidity of alcohol misuse or aggressive behaviors with depression or PTSD, and (3) compare rates between Active Component and National Guard soldiers at the 3- and 12-month time points following their deployment to Iraq.

DESIGN

Population-based, cross-sectional study.

SETTING

United States Army posts and National Guard armories.

PARTICIPANTS

A total of 18 305 US Army soldiers from 4 Active Component and 2 National Guard infantry brigade combat teams.

INTERVENTIONS

Between 2004 and 2007, anonymous mental health surveys were collected at 3 and 12 months following deployment.

MAIN OUTCOME MEASURES

Current PTSD, depression, functional impairment, alcohol misuse, and aggressive behavior.

RESULTS

Prevalence rates for PTSD or depression with serious functional impairment ranged between 8.5% and 14.0%, with some impairment between 23.2% and 31.1%. Alcohol misuse or aggressive behavior comorbidity was present in approximately half of the cases. Rates remained stable for the Active Component soldiers but increased across all case definitions from the 3- to 12-month time point for National Guard soldiers.

CONCLUSIONS

The prevalence rates of PTSD and depression after returning from combat ranged from 9% to 31% depending on the level of functional impairment reported. The high comorbidity with alcohol misuse and aggression highlights the need for comprehensive postdeployment screening. Persistent or increased prevalence rates at 12 months compared with 3 months postdeployment illustrate the persistent effects of war zone service and provide important data to guide postdeployment care.

Authors+Show Affiliations

Walter Reed Army Institute of Research, Department of Military Psychiatry, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA. jeffrey.l.thomas@us.army.milNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

20530011

Citation

Thomas, Jeffrey L., et al. "Prevalence of Mental Health Problems and Functional Impairment Among Active Component and National Guard Soldiers 3 and 12 Months Following Combat in Iraq." Archives of General Psychiatry, vol. 67, no. 6, 2010, pp. 614-23.
Thomas JL, Wilk JE, Riviere LA, et al. Prevalence of mental health problems and functional impairment among active component and National Guard soldiers 3 and 12 months following combat in Iraq. Arch Gen Psychiatry. 2010;67(6):614-23.
Thomas, J. L., Wilk, J. E., Riviere, L. A., McGurk, D., Castro, C. A., & Hoge, C. W. (2010). Prevalence of mental health problems and functional impairment among active component and National Guard soldiers 3 and 12 months following combat in Iraq. Archives of General Psychiatry, 67(6), 614-23. https://doi.org/10.1001/archgenpsychiatry.2010.54
Thomas JL, et al. Prevalence of Mental Health Problems and Functional Impairment Among Active Component and National Guard Soldiers 3 and 12 Months Following Combat in Iraq. Arch Gen Psychiatry. 2010;67(6):614-23. PubMed PMID: 20530011.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence of mental health problems and functional impairment among active component and National Guard soldiers 3 and 12 months following combat in Iraq. AU - Thomas,Jeffrey L, AU - Wilk,Joshua E, AU - Riviere,Lyndon A, AU - McGurk,Dennis, AU - Castro,Carl A, AU - Hoge,Charles W, PY - 2010/6/10/entrez PY - 2010/6/10/pubmed PY - 2010/6/16/medline SP - 614 EP - 23 JF - Archives of general psychiatry JO - Arch Gen Psychiatry VL - 67 IS - 6 N2 - CONTEXT: A growing body of literature has demonstrated the association of combat in Iraq and Afghanistan with postdeployment 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. OBJECTIVES: To (1) examine the prevalence rates of depression and PTSD using several case definitions including functional impairment, (2) determine the comorbidity of alcohol misuse or aggressive behaviors with depression or PTSD, and (3) compare rates between Active Component and National Guard soldiers at the 3- and 12-month time points following their deployment to Iraq. DESIGN: Population-based, cross-sectional study. SETTING: United States Army posts and National Guard armories. PARTICIPANTS: A total of 18 305 US Army soldiers from 4 Active Component and 2 National Guard infantry brigade combat teams. INTERVENTIONS: Between 2004 and 2007, anonymous mental health surveys were collected at 3 and 12 months following deployment. MAIN OUTCOME MEASURES: Current PTSD, depression, functional impairment, alcohol misuse, and aggressive behavior. RESULTS: Prevalence rates for PTSD or depression with serious functional impairment ranged between 8.5% and 14.0%, with some impairment between 23.2% and 31.1%. Alcohol misuse or aggressive behavior comorbidity was present in approximately half of the cases. Rates remained stable for the Active Component soldiers but increased across all case definitions from the 3- to 12-month time point for National Guard soldiers. CONCLUSIONS: The prevalence rates of PTSD and depression after returning from combat ranged from 9% to 31% depending on the level of functional impairment reported. The high comorbidity with alcohol misuse and aggression highlights the need for comprehensive postdeployment screening. Persistent or increased prevalence rates at 12 months compared with 3 months postdeployment illustrate the persistent effects of war zone service and provide important data to guide postdeployment care. SN - 1538-3636 UR - https://www.unboundmedicine.com/medline/citation/20530011/Prevalence_of_mental_health_problems_and_functional_impairment_among_active_component_and_National_Guard_soldiers_3_and_12_months_following_combat_in_Iraq_ L2 - https://jamanetwork.com/journals/jamapsychiatry/fullarticle/10.1001/archgenpsychiatry.2010.54 DB - PRIME DP - Unbound Medicine ER -