BackgroundPosttraumatic stress disorder (PTSD) often co-occurs with other psychiatric disorders, particularly major depressive disorder (MDD). The current study examined longitudinal trajectories of PTSD and MDD symptoms among service members and veterans with comorbid PTSD/MDD.MethodsEligible participants (n = 1704) for the Millennium Cohort Study included those who screened positive at baseline for both PTSD (PTSD Checklist–Civilian Version) and MDD (Patient Health Questionnaire). Between 2001 and 2016, participants completed a baseline assessment and up to 4 follow-up assessments approximately every 3 years. Mixture modeling simultaneously determined trajectories of comorbid PTSD and MDD symptoms. Multinomial regression determined factors associated with latent class membership.ResultsFour distinct classes (chronic, relapse, gradual recovery, and rapid recovery) described symptom trajectories of PTSD/MDD. Membership in the chronic class was associated with older age, service branch, deployment with combat, anxiety, physical assault, disabling injury/illness, bodily pain, high levels of somatic symptoms, and less social support.ConclusionsComorbid PTSD/MDD symptoms tend to move in tandem, and, although the largest class remitted symptoms, almost 25% of participants reported chronic comorbid symptoms across all time points. Results highlight the need to assess comorbid conditions in the context of PTSD. Future research should further evaluate the chronicity of comorbid symptoms over time.

IMPORTANCE Few studies have examined the role of problematic anger in long-term adjustment of service members transitioning out of the military. OBJECTIVE To determine the prevalence of problematic anger during the military-to-civilian transition period and the association of problematic anger with adjustment to civilian life.

O ccupation-related mental distress is widely known to affect health-care professionals at greater rates than that experienced by the general population. 1,2 Moreover, studies 1,3-7 of health-care professionals have found greater occurrences of mental illness among veterinarians than among other medical professionals (eg, physicians, dentists, and nurses). Previous investigations have identified a higher frequency of depression, 1,5,6 anxiety, 1,5 psychological distress, 8 psychotropic medication use, problem (alcohol) drinking, 9,10 and suicide 1,4,7,11-16 among veterinarians and veterinary students than among the general population.

Declining survey response rates concern researchers aiming to ensure study validity. This article tested the effectiveness of multiple pre-incentives on increasing survey response to the Millennium Cohort Study. Participants consisted of U.S. military service members and veterans, and were randomly assigned to receive a $2 bill, $5 gift card, magnet, Apple iPad® lottery entry, or no pre-incentive. Participants who received the gift card or cash pre-incentive had the highest response rates and were significantly more likely to respond to the survey than those who did not receive a pre-incentive. There was no significant difference in survey response among the magnet or lottery entry groups compared to the no pre-incentive group. This study found that giving participants a monetary pre-incentive was an effective way to increase response rates, and thereby participant retention, in a hard-to-reach, highly mobile population, and re-engage participants who did not respond to a previous follow-up survey.