Study Examines Mental and Physical Health — and Substance Use in Veterans One Year after Deployment to Iraq or Afghanistan
While most Veterans return from deployment without suffering long-term consequences, a significant number experience serious psychological harm. Moreover, mental health problems are often compounded by problems with physical health. Recent conflicts have resulted in more than 46,000 soldiers wounded in action, some with serious and debilitating conditions such as chronic pain, traumatic brain injury, and high risk for cardiovascular disease. This observational study sought to examine mental and physical health symptoms and functioning, as well as alcohol and drug use, in a national sample of Veterans within one year of returning from deployment in Afghanistan (OEF) or Iraq (OIF). Investigators also assessed differences in outcomes by gender, service component (Active, National Guard, Reserve), branch (Army, Navy, Air Force, Marines), and deployment operation (OEF or OIF). Surveys were mailed to 1,833 Veterans in November 2008, and 596 Veterans returned completed surveys by the end of 2009. Surveys included established, reliable, and valid self-report instruments used to assess mental and physical health symptoms and functioning. Women were oversampled to comprise 50% of respondents, and National Guard/Reserve to each comprise 25%.
- Within one year of returning from deployment, OEF/OIF Veterans in this study reported significantly worse mental health functioning than the general population. In addition, 39% screened positive for "probable alcohol abuse," which is considerably higher than numbers reported based on mandated screening of VA outpatients.
- OIF (Iraq) Veterans reported more depression/functioning problems, as well as alcohol and drug use than OEF (Afghanistan) Veterans.
- Marine and Army Veterans reported worse mental and physical health than Air Force or Navy Veterans. For example, 25% of Marines and 15% of Army respondents screened positive for probable PTSD compared with 10% of Air Force and 6% of Navy Veterans.
- Men reported more alcohol and drug use than women, but there were no gender differences in PTSD or other mental health domains. However, it is important to note that women experience less intense combat than men.
- The authors suggest that continued identification of Veterans at risk for mental health and substance use problems is important for the development and implementation of evidence-based interventions intended to increase resilience and enhance treatment.
- Due to the retrospective study design, one cannot infer that the physical/mental health status of respondents is directly attributable to deployment.
- Self-report was used for mental health and substance use, which may be subject to bias.
This study was partly funded by HSR&D (IAC 06 259). Drs. Eisen and Schultz are part of HSR&D's Center for Health Quality, Outcomes, and Economic Research, Bedford, MA.
Eisen S, Schultz M, Vogt D, et al. Mental and Physical Health Status, Alcohol and Drug Use Following Return from Deployment to Iraq or Afghanistan. American Journal of Public Health 2012 Mar;102 Suppl 1:S66-73.