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Poor mental health symptoms increase over time among military personnel

Self-reported symptoms of poor mental health increased over time among military personnel in the United Kingdom, potentially contributing to overall rates of poor mental health, according to findings in the Journal of the Royal Army Medical Corps.

“Exposure to traumatic incidents, commonplace in combat zones, increases the risk of developing posttraumatic stress disorder (PTSD), depression and anxiety. However, the risk of developing mental illness appears to vary between troops. PTSD rates for U.K. combat personnel vary from 2.7% to 7% whereas in U.S. studies, rates are generally higher, for example 13.8%, and can increase over follow-up,” Elizabeth Banwell, PhD, of King’s College London, and colleagues wrote.

To assess potential improvement in PTSD, common mental disorders and sleep among military personnel, researchers evaluated 2,580 regular or reserve military personnel from all ranks of the U.K. Army, Navy, Royal Marines or Royal Air force who completed an operational tour in Afghanistan and returned to the United Kingdom via Third Location Decompression. Combat exposure was assessed at baseline. Researchers used the 17-item National Centre for Posttraumatic Stress Disorder Checklist, civilian version (PCL-C), the 12-item General Health Questionnaire, the General Anxiety Disorder scale and the Patient Health Questionnaire to measure PTSD symptoms, psychiatric disturbance, core anxiety symptoms and depression. Follow-up included 296 baseline participants.

Researchers found that all measures of common mental disorders increased from baseline except for sleep dissatisfaction, though only PTSD symptoms increased significantly.

The mean difference of three PCL-C scale points was not clinically significant but suggests an increase in probable PTSD rates over time, according to researchers.

Baseline symptoms of poor mental health were predictive of adjustment and relationship difficulties after returning from deployment. Symptoms of common mental disorders were the strongest predictors of these difficulties.

The finding that symptoms of common mental disorders were more predictive than PTSD symptoms is interesting, according to researchers, and may be due to individuals’ tendency to avoid discussing PTSD symptoms during early homecoming.

“The study’s results suggest that there may be opportunities to provide brief evidence-based interventions during the homecoming process. These would aim to help troops understand why their symptoms exist and to utilize cognitive techniques to help them make sense of the various experiences they had been through during deployment,” Neil Greenberg, BM, BSc, MMedSc, FHEA, MFMLM, DOccMed, MEWI, MFFLM, MD, FRCPsych, of King’s College London, said in a press release. “We think this study has some really important implications — not only for U.K. troops but also for their families, who can be a crucial source of social support, especially during the homecoming period.” – by Amanda Oldt

Disclosure: Please see the full study for a list of all authors’ relevant financial disclosures.