Fear NT, Jones M, Murphy D, Hull L, Sundin J, Iversen AC et al. What are the consequences of deployment to Iraq and Afghanistan on the mental health of the UK armed forces? A cohort study. Lancet 375: 1783-1797

Academic Centre for Defence Mental Health, King's College London, London, UK.
The Lancet (Impact Factor: 45.22). 05/2010; 375(9728):1783-97. DOI: 10.1016/S0140-6736(10)60672-1
Source: PubMed


Concerns have been raised about the psychological effect of continued combat exposure and of repeated deployments. We examined the consequences of deployment to Iraq and Afghanistan on the mental health of UK armed forces from 2003 to 2009, the effect of multiple deployments, and time since return from deployment.
We reassessed the prevalence of probable mental disorders in participants of our previous study (2003-05). We also studied two new randomly chosen samples: those with recent deployment to Afghanistan, and those who had joined the UK armed forces since April, 2003, to ensure that the final sample continued to be representative of the UK armed forces. Between November, 2007, and September, 2009, participants completed a questionnaire about their deployment experiences and health outcomes.
9990 (56%) participants completed the study questionnaire (8278 regulars, 1712 reservists). The prevalence of probable post-traumatic stress disorder was 4.0% (95% CI 3.5-4.5; n=376), 19.7% (18.7-20.6; n=1908) for symptoms of common mental disorders, and 13.0% (12.2-13.8; n=1323) for alcohol misuse. Deployment to Iraq or Afghanistan was significantly associated with alcohol misuse for regulars (odds ratio 1.22, 95% CI 1.02-1.46) and with probable post-traumatic stress disorder for reservists (2.83, 1.23-6.51). Regular personnel in combat roles were more likely than were those in support roles to report probable post-traumatic stress disorder (1.87, 1.26-2.78). There was no association with number of deployments for any outcome. There was some evidence for a small increase in the reporting of probable post-traumatic stress disorder with time since return from deployment in regulars (1.13, 1.03-1.24).
Symptoms of common mental disorders and alcohol misuse remain the most frequently reported mental disorders in UK armed forces personnel, whereas the prevalence of probable post-traumatic stress disorder was low. These findings show the importance of continued health surveillance of UK military personnel.
UK Ministry of Defence.

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    • "Based on the assumption that the data are missing at random and that the observed variables modelled to drive nonresponse were correctly identified, the weighted analyses provide valid results. A combined weight was generated by multiplying the sample and response weights (Fear et al., 2010). All analyses were conducted in STATA 11.0 (StataCorp, 2009) and used the survey commands and sampling weights. "
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    • "The second, referred to as the 'replenishment' sample, included a random sample of 2665 individuals who joined the UK Armed Forces between April 2003 and April 2007 (response rate 40%). In total, 9990 individuals completed the phase 2 questionnaire (overall response rate 56%) (Fear et al. 2010). Although this cohort included both regulars and reservists, and serving and ex-serving personnel, in the current study the military sample was restricted to regulars who were in service at phase 1 (N = 7786) or phase 2 (N = 6511). "
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    • "We have shown that mental health status and multiple symptom status at phase 1 was not associated with participation at phase 2 of the study (Fear et al., 2010). Further details are available elsewhere (Fear et al., 2010). "
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