A Prospective Study of Depression Following Combat Deployment in Support of the Wars in Iraq and Afghanistan

Abstract

Objective. We investigated relations between deployment and new-onset depression among US service members recently deployed to the wars in Iraq and Afghanistan. Methods. We included 40 219 Millennium Cohort Study participants who completed baseline and follow-up questionnaires and met inclusion criteria. Participants were identified with depression if they met the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire criteria for depression at follow-up, but not at baseline. Results. Deployed men and women with combat exposures had the highest onset of depression, followed by those not deployed and those deployed without combat exposures. Combat-deployed men and women were at increased risk for new-onset depression compared with nondeployed men and women (men: adjusted odds ratio [AOR] = 1.32; 95% confidence interval [CI] = 1.13, 1.54; women: AOR = 2.13; 95% CI = 1.70, 2.65). Conversely, deployment without combat exposures led to decreased risk for new-onset depression compared with those who did not deploy (men: AOR = 0.66; 95% CI = 0.53, 0.83; women: AOR = 0.65; 95% CI = 0.47, 0.89). Conclusions. Deployment with combat exposures is a risk factor for new-onset depression among US service members. Post-deployment screening may be beneficial for US service members exposed to combat.

Effects of Iraq/Afghanistan Deployments on Major Depression and Substance Use Disorder: Analysis of Active Duty Personnel in the US Military

“…It was not surprising that our overall rates of depression and substance use disorder because of alcohol were lower than those reported in MCS, because MCS identified conditions through surveys, whereas we identified conditions through TRICARE health records. The overall rate of new onset of depression in MCS was 4% (Wells et al 14 ; Tables 2 and 3), whereas our overall rate of major depression was 2% (see the online appendixes, available at http://www.ajph. org).…”

“…The MCS found that men and women deployed with combat exposure had, respectively, 1.32 and 2. 13 times the odds of having depression compared with those not deployed 14 and found weak evidence of any impact of a combat deployment on drinking outcomes among active duty respondents. 15 Besides the MCS, 1 study, using a 2008 Department of Defense Health Related Behaviors Survey, found that service members with any combat deployment had significantly higher rates of heavy alcohol and cigarette use.…”

Combat exposure and migraine headache: Evidence from exogenous deployment assignment

“…The most common identification strategy used in the medical literature (see, for example, Wells et al, 2010;Smith et al, 2009;Jacobson et al, 2008) has been to compare those deployed to combat with non-deployed active duty and reservist soldiers. However, non-deployment may not be exogenous, as selection into the Reserves or National Guard-which comprise a relatively larger share of non-deployed armed services personnel than active duty soldiers-may be nonrandom (Hirsch and Mahey, 2003) and active-duty soldiers who remain non-deployed for long periods of time may be non-deployable for reasons related to physical or mental health (Department of the Army AR 614-30, 2010;Cesur et al, 2011).…”

Deployment-related mental disorders among Canadian Forces personnel deployed in support of the mission in Afghanistan, 2001–2008

“…Data from Canada's closest allies [1][2][3][4][5][6][7] have shown that an important minority of their personnel deployed to the conflicts in Southwest Asia have mental health problems, many apparently related to their deployment. Mental disorders have important implications for military and veteran organizations and are leading causes of impaired productivity, 8 absenteeism 8 and turnover.…”