Research Highlights
Study suggests rise in wars' mental toll
August 3, 2009
Among nearly 290,000 veterans of the wars in Iraq and Afghanistan who used VA health care for the first time between April 2002 and March 2008, 37 percent received a mental-health diagnosis.
That's the main result of a database study by a team with VA and the University of California, San Francisco. The findings appeared online July 17 in the American Journal of Public Health.
An earlier study by the same group looked at 100,000 veterans of operations Enduring Freedom and Iraqi Freedom who were first seen in VA between 2001 and 2005. The study found that a quarter of them had at least one mental health diagnosis. "What's really striking is the dramatic acceleration in mental health diagnoses, particularly PTSD, after the beginning of the conflict in Iraq [in 2003]," said lead author Karen Seal, MD, MPH, noting that no such trend was seen after U.S. forces began fighting in Afghanistan in 2001.
In the latest study, nearly 22 percent of the veterans had PTSD. Among veterans who had been on active duty, PTSD was nearly twice as common in the youngest cohort—those under age 25—as in those over age 40. Among National Guard and Reserve veterans, the trend was reversed: Older veterans were at higher risk than their younger peers for PTSD.
Active-duty veterans who were of enlisted rank, who served in the Army rather than other service branches, or who had multiple tours of duty—all factors linked with greater combat exposure—were more likely to have PTSD.
Other common diagnoses were depression, seen in 17 percent of the veterans, with women at higher risk than men; alcohol use disorder, affecting 7 percent of the veterans; and drug use disorder, 3 percent. A third of those with mental health problems had three or more different conditions.
The study didn't explore why there was a sharp uptick in mental health issues following the start of the Iraq war. But the authors say possible reasons include "waning public support and lower morale among troops, as occurred during the Vietnam war era," along with a war zone characterized by unpredictable threats, such as from roadside bombs. They also cite increasing media attention and multiple, longer deployments. To address the trends noted in the study, the authors recommend targeted screening for mental health problems and early interventions tailored to the problems of particular subgroups of veterans, such as women, young men under age 25, and Guard and Reserve members over 40.
This article originally appeared in the August 2009 issue of VA Research Currents.