Incidence of major depression diagnoses in the Canadian Armed Forces: longitudinal analysis of clinical and health administrative data

Abstract

Purpose Major depression is a leading cause of morbidity in military populations. However, due to a lack of longitudinal data, little is known about the rate at which military personnel experience the onset of new episodes of major depression. We used a new source of clinical and administrative data to estimate the incidence of major depression diagnoses in Canadian Armed Forces (CAF) personnel, and to compare incidence rates between demographic and occupational factors. Methods We extracted all data recorded in the electronic medical records of CAF Regular Force personnel, at every primary care and mental health clinical encounter since 2016. Using a 12-month lookback period, we linked data over time, and identified all patients with incident diagnoses of major depression. We then linked clinical data to CAF administrative records, and estimated incidence rates. We used multivariate Poisson regression to compare adjusted incidence rates between demographic and occupational factors. Results From January to December 2017, CAF Regular Force personnel were diagnosed with major depression at a rate of 29.2 new cases per 1000 person-years at risk. Female sex, age 30 years and older, and non-officer ranks were associated with significantly higher incidence rates. Conclusions We completed the largest study to date on diagnoses of major depression in the Canadian military, and have provided the first estimates of incidence rates in CAF personnel. Our results can inform future mental health resource allocation, and ongoing major depression prevention efforts within the Canadian Armed Forces and other military organizations.

The global prevalence of depression, suicide ideation, and attempts in the military forces: a systematic review and Meta-analysis of cross sectional studies

“…The navy has more professional problems in terms of special professional missions, and more psychological problems than the army and the air Force. Job-related stress, complex missions, strict rules, the possibility of injury, disability, captivity and even death are some of the issues that increase the likelihood of depression in these soldiers compared to others [ 46 , 47 ]. A person’s psychological capacity includes a person’s ability to cope with the expectations and difficulties of everyday life.…”

The Global Prevalence of Depression, Suicide Ideation, and Attempts in the Military Forces: A Systematic Review and Meta-Analysis of Cross Sectional Studies

“…The navy has more professional problems in terms of special professional missions, and more psychological problems than the army and the air Force. Job-related stress, complex missions, strict rules, the possibility of injury, disability, captivity and even death are some of the issues that increase the likelihood of depression in these soldiers compared to others (41,42). A person's psychological capacity includes a person's ability to cope with the expectations and di culties of everyday life.…”

Women Veterans of the Canadian Armed Forces and Royal Canadian Mounted Police: A scoping review

“…Mots-clés : Anciens combattants Canada, analyse bibliographique, Canada, FAC, Forces armées canadiennes, Gendarmerie royale du Canada, GRC, militaire, vétéranes the search was limited to documents published before Dec. 31,2020, that were written in English, came to novel conclusions, and relied on Canadian data disaggregated by sex, gender, or both.…”

“…13,22,29,30 Women in the CAF face significantly higher rates of depression than men CAF members and women in the CGP. 20 Compared with men members, they are more likely to have major depression, 31 a panic disorder, a social phobia, generalized anxiety disorder, or posttraumatic stress disorder (PTSD) and to have comorbid mental health issues. [32][33][34][35] Women CAF Veterans have poorer self-rated mental health than men CAF Veterans.…”