The health of UK military personnel who deployed to the 2003 Iraq War a cohort study

King's Centre for Military Health Research, King's College London, London, UK.
The Lancet (Impact Factor: 45.22). 06/2006; 367(9524):1731-41. DOI: 10.1016/S0140-6736(06)68662-5
Source: PubMed

ABSTRACT Concerns have been raised about the mental and physical health of UK military personnel who deployed to the 2003 war in Iraq and subsequent tours of duty in the country.
We compared health outcomes in a random sample of UK armed forces personnel who were deployed to the 2003 Iraq war with those in personnel who were not deployed. Participants completed a questionnaire covering the nature of the deployment and health outcomes, which included symptoms of post-traumatic stress disorder, common mental disorders, general wellbeing, alcohol consumption, physical symptoms, and fatigue.
The participation rate was 62.3% (n=4722) in the deployed sample, and 56.3% (n=5550) in the non-deployed sample. Differences in health outcomes between groups were slight. There was a modest increase in the number of individuals with multiple physical symptoms (odds ratio 1.33; 95% CI 1.15-1.54). No other differences between groups were noted. The effect of deployment was different for reservists compared with regulars. In regulars, only presence of multiple physical symptoms was weakly associated with deployment (1.32; 1.14-1.53), whereas for reservists deployment was associated with common mental disorders (2.47, 1.35-4.52) and fatigue (1.78; 1.09-2.91). There was no evidence that later deployments, which were associated with escalating insurgency and UK casualties, were associated with poorer mental health outcomes.
For regular personnel in the UK armed forces, deployment to the Iraq war has not, so far, been associated with significantly worse health outcomes, apart from a modest effect on multiple physical symptoms. There is evidence of a clinically and statistically significant effect on health in reservists.

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Available from: Tess E Browne, Sep 28, 2015
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    • "In total, 10 299 participants responded [8711 regulars, 1588 reservists (including late responders ); 59% response rate]. Of the participants who completed phase 1 of the study, 5905 had been deployed to Op TELIC 1 before they completed the questionnaire (Hotopf et al. 2006). For phase 2, 9395 participants from phase 1 were available for follow-up, including 37 who returned a completed phase 1 questionnaire after the end of data collection. "
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    ABSTRACT: Although the military is considered to be a stressful occupation, there are remarkably few studies that compare the prevalence of common mental disorder (CMD) between the military and the general population. This study examined the prevalence of probable CMD in a serving UK military sample compared to a general population sample of employed individuals. Method Data for the general population was from the 2003 and 2008 collections for the Health Survey for England (HSE) and for the serving military from phases 1 (2004���2006) and 2 (2007���2009) of the King's Centre for Military Health Research (KCMHR) cohort study. Probable CMD was assessed by the General Health Questionnaire (GHQ-12). The datasets were appended to calculate the odds of CMD in the military compared to the general population. The odds of probable CMD was approximately double in the military, when comparing phase 1 of the military study to the 2003 HSE [odds ratio (OR) 2.4, 95% confidence interval (CI) 2.1���2.7], and phase 2 to the 2008 HSE (OR 2.3, 95% CI 2.0���2.6) after adjustment for sex, age, social class, education and marital status. Serving military personnel are more likely to endorse symptoms of CMD compared to those selected from a general population study as employed in other occupations, even after accounting for demographic characteristics. This difference may be partly explained by the context of the military study, with evidence from previous research for higher reports of symptoms from the GHQ in occupational compared to population studies, in addition to the role of predisposing characteristics.
    Psychological Medicine 01/2015; 45(09):1-11. DOI:10.1017/S0033291714002980 · 5.94 Impact Factor
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    • "Although this sample gave a substantial picture of the UK military, including reservists, it was not a representative sample of the entire defence force. The first wave recorded a similar prevalence of 20% for the presence of a common mental disorder using the 12- item self-report General Health Questionnaire (GHQ-12) and 4% for PTSD using the PCL-C (Hotopf et al., 2006). Additional assessment using the PHQ, and the 4-item Primary Care PTSD (PC-PTSD) administered via interview resulted in disorder rates of 28.9% overall, 4.8% with probable PTSD, 3.7% with major depressive syndrome, and 18% with alcohol abuse, with PTSD being relatively consistent between those who had deployed and never deployed (Iversen et al., 2009; Jones et al., 2013). "
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    ABSTRACT: Background The Australian Defence Force (ADF) Mental Health Prevalence and Wellbeing Study (MHPWS) is the first study of mental disorder prevalence in an entire military population. Objective The MHPWS aims to establish mental disorder prevalence, refine current ADF mental health screening methods, and identify specific occupational factors that influence mental health. This paper describes the design, sampling strategies, and methodology used in this study. Method At Phase 1, approximately half of all regular Navy, Army, and Air Force personnel (n=24,481) completed self-report questionnaires. At Phase 2, a stratified sub-sample (n=1,798) completed a structured diagnostic interview to detect mental disorder. Based on data from non-responders, data were weighted to represent the entire ADF population (n=50,049). Results One in five ADF members met criteria for a 12-month mental disorder (22%). The most common disorder category was anxiety disorders (14.8%), followed by affective (9.5%) and alcohol disorders (5.2%). At risk ADF sub-groups were Army personnel, and those in the lower ranks. Deployment status did not have an impact on mental disorder rates. Conclusion This study has important implications for mental health service delivery for Australian and international military personnel as well as contemporary veterans.
    European Journal of Psychotraumatology 08/2014; 5. DOI:10.3402/ejpt.v5.23950 · 2.40 Impact Factor
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    • "for anxiety disorders 4.5Á7.9%, and for alcohol abuse 13Á26% (Fear et al., 2010; Hoge et al., 2004; Hotopf et al., 2006; Iversen et al., 2009). "
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    ABSTRACT: Military deployment to combat zones puts military personnel to a number of physical and mental challenges that may adversely affect mental health. Until now, few studies have been performed in Europe on mental health utilization after military deployment.
    European Journal of Psychotraumatology 08/2014; 5. DOI:10.3402/ejpt.v5.23667 · 2.40 Impact Factor
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