la guerra non è un gioco

Posttraumatic stress disorder

(PTSD) and depression are serious problems for soldiers who return home from the wars in Iraq and Afghanistan, according to a new study published in the Archives of General Psychiatry. An average of 10 percent of returning soldiers suffer from these mental health disorders, with many displaying violent behavior as well.

Previous studies of the impact on the mental health of soldiers in combat in Iraq and Afghanistan have highlighted a growing problem. In a 2006 report in the Journal of the American Medical Association, it was found that one-third of US military personnel from the war in Iraq accessed mental health services after they returned home. Among 222,620 Iraq veterans, 31 percent had at least 1 outpatient mental health visit within the first year postdeployment, while the annualized rate of such services was 35 percent.

Subsequent studies have illustrated an association between combat in Iraq and Afghanistan and mental health problems post-deployment, including PTSD and depression. This latest study, conducted at Walter Reed Army Institute of Research, took a closer look at this growing challenge.

Mental health surveys were collected anonymously between 2004 and 2007 from 18,305 US Army soldiers three and 12 months postdeployment. The soldiers were screened for depression, alcohol misuse, PTSD, and aggressive behavior. The soldiers were also asked whether any of these challenges caused difficulties at home, work, or socially.

The study’s authors note that when utilizing the least stringent definition of PTSD, they found rates ranging from 20.7 to 30.5 percent, and depression rates ranging from 11.5 to 16 percent. When they employed the strictest definitions of both conditions, they found a PTSD prevalence of 5.6 to 11.3 percent and for depression, 5 to 8.5 percent. Aggressive behavior or alcohol misuse was also present in about 50 percent of the soldiers who had PTSD or depression.

The study subjects included members of four Active Component (non-reserve) and two National Guard (reserve) infantry brigade combat teams. Researchers observed an increase in depression and PTSD rates among National Guard soldiers between the three- and 12-month time points but not among the Active Component soldiers, despite their having similar combat experiences. The authors suggested that the differences did not appear to be associated with differences in the health impact of combat “but rather with other variables related to readjustment to civilian life or access to health care.”

The results of this study highlight the fact that “at 12 months following combat, the prevalence of mental health problems among veterans does not abate, and in many cases, increases.” The far-reaching consequences of these disturbing findings touch the returning soldiers, their families, and their peers. Redeploying soldiers who are suffering with PTSD or depression “could impair their performance in combat” and also “has implications for the safety of unit members and mission success.”

SOURCES:
Thomas JL et al. Archives of General Psychiatry 2010; 67(6): 614-23
Hoge CW et al. JAMA 2006; 295:1023-32