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Prevalence of common mental disorders high among Iraq/Afghanistan veterans

Past deployment to Iraq or Afghanistan was linked to higher rates of common mental disorders and probable PTSD among ex-military service personnel in the United Kingdom, according to findings published in British Journal of Psychiatry.

Furthermore, the results showed that ex-servicemembers who had deployed in a combat role had the highest levels of PTSD and common mental disorders.

“Since 2001, more than 280,000 U.K. service personnel deployed to Iraq and Afghanistan, some on multiple occasions. Many of those who deployed are likely to have been exposed to potentially traumatic events,” Sharon A.M. Stevelink, PhD, of King’s Centre for Military Health Research, and colleagues wrote. “It is essential to ensure long-term follow-up of these individuals to understand the consequences of deployment, including once personnel have left military service.”

According to the researchers, a study established in 2003 assessed the potential impact of deployment to Iraq on the health and well-being of U.K. service personnel and reported two waves of data in 2004 to 2006 and 2007 to 2009. These results showed no overall excess of mental health consequences at the population level among those who deployed compared with other military members who had not deployed; but, the investigators found that reserves and those who experienced direct combat were at an increased risk for mental illness and alcohol misuse.

In the current study, Stevelink and colleagues reported the main outcomes of the third wave of this cohort (2014 to 2016).

The researchers evaluated the prevalence of mental disorders and alcohol misuse, as well as whether this prevalence differed between serving and ex-serving military personnel and by deployment status, in 8,093 participants. The sample, based on participants from the previous two phases, also consisted of a randomly selected number of personnel who had joined the U.K. armed forces since 2009.

Of the participants, 61.9% had deployed to Iraq or Afghanistan. Overall, 21.9% of participants reported symptoms of common mental disorders (95% CI, 20.75-23.01), 6.2% reported probable PTSD (95% CI, 5.49-6.89) and 10% reported alcohol misuse (95% CI, 9.2-10.9).

The findings revealed a significant interaction between deployment status and engagement

type (regular or reserve status) on common mental disorders (P = .002), which showed a higher prevalence of mental disorders in deployed reserves compared with deployed regulars. Reserves who had deployed continued to report significantly more symptoms of common mental illnesses, probable PTSD and alcohol misuse compared with those who did not deploy. Deployed regulars also showed higher levels of PTSD and alcohol misuse than those who had not deployed.

Probable PTSD and alcohol misuse were significantly linked with serving status, according to Stevelink and colleagues. Ex-serving members were at significantly higher risk for probable PTSD (adjusted OR = 1.73; 95% CI, 1.25-2.4) and alcohol misuse (adjusted OR = 1.35; 95% CI, 1.08-1.7) than those currently serving. The report also indicated a connection between deployment status and serving status for probable PTSD (P < .001) and alcohol misuse (P < .01).

Ex-serving members who held a combat role were significantly more likely to report symptoms of common mental disorder and PTSD than those who deployed in a combat service support role (adjusted OR = 1.7; 95% CI, 1.28-2.41 and adjusted OR = 2.53; 95% CI, 1.6-3.99).

“The study data suggests that transition and civilian life may be particularly problematic for an important minority of U.K. Service personnel. As seen previously with regards to mental health legacy issues, such as those from the Vietnam War, these have taken some time to reveal themselves,” the researchers wrote. “These results reiterate the importance of taking a lifelong approach to the health and well-being of the armed forces to ensure that both serving and ex-serving personnel receive optimal care.” – by Savannah Demko

Disclosure: The authors report no relevant financial disclosures.