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Health Services Research & Development

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2008 HSR&D National Meeting Abstract

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National Meeting 2008

1034 — MST in Veterans Returning from Iraq and Afghanistan: The “Other” Deployment Stressor

Kimerling R (VA Palo Alto HCS), Pavo J (VA Palo Alto HCS), Gima K (VA Palo Alto HCS), Street A (VA Boston HCS), Smith M (VA Palo Alto HCS), Cronkite R (VA Palo Alto HCS), Frayne S (VA Palo Alto HCS)

Objectives:
To date, no research has examined the impact of military sexual trauma (MST) among veterans recently returned from Iraq and Afghanistan (OIF/OEF). We examined the association of MST with mental health conditions among OIF/OEF veterans in VA.

Methods:
This is a cross-sectional analysis of 89,960 OIF/OEF veteran patients who had a post-discharge face-to-face medical or mental health visit at a VA facility during the time period of October 1, 2002 to October 1, 2006 and were screened using the MST clinical reminder in CPRS. Mental health conditions were abstracted from outpatient event files and quantified using non-overlapping MHSA-CCS categories. Odds ratios were used to assess associations of MST with these categories. Analyses were stratified by gender.

Results:
MST was reported by 14.5% (1,849) of women and 0.6% (471) of men. Mental health conditions were diagnosed in 71.6% of women and 73.9% of men who reported MST. MST was associated with increased risk for all categories of mental health conditions, including depressive disorders, PTSD, and substance use disorders (OR=3.24, 95%CI(2.93-3.59); OR=4.05, 95%CI(3.64-4.49); and OR=3.04, 95%CI(2.53-3.66), respectively for women) and (OR=2.87, 95%CI(2.39-3.45); OR=2.74, 95%CI(2.29-3.29); and OR=2.09, 95%CI(1.65-2.64), for men). MST was also associated with multiple diagnoses, with an almost sixfold increase in risk for three or more mental health conditions (OR=5.97, 95% CI=5.19-6.85 for women, OR=5.74, 95% CI=4.52-7.28 for men)

Implications:
A substantial proportion of veterans screened during VA healthcare visits reported recent sexual trauma. These experiences are associated with a wide range of mental health conditions and are strongly associated with multiple comorbid conditions.

Impacts:
Care for OIF/ OEF veterans is a high priority for VA's mental health care system. All veterans are also entitled by public law to MST-related care free of charge regardless of VA eligibility. Veterans who present with recent sexual trauma have complex mental health needs. VA should ensure access to appropriate services for patients and clinician training regarding sexual trauma in men and women.


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