Lifetime Prevalence and Comorbidity of Mental Disorders in the Two-wave 2002–2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (CAFVMHS): Prévalence et Comorbidité de Durée de vie Des Troubles Mentaux Dans l’Enquête de Suivi Sur la Santé Mentale Auprès des Membres des Forces Armées Canadiennes et Des ex-Militaires (ESSMFACM) en Deux Cycles de 2002 à 2018

Abstract

Objective: The current study used the Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (CAFVMHS) to (1) examine the incidence and prevalence of mental disorders and (2) estimate the comorbidity of mental disorders over the follow-up period. Method: The CAFVMHS (2018) is a longitudinal study with two time points of assessment. The sample is comprised of 2,941 Canadian Forces members and veterans who participated in the 2002 Canadian Community Health Survey: Canadian Forces Supplement. The World Health Organization Composite International Diagnostic Interview (WHO-CIDI) was utilized to diagnose Diagnostic and Statistical Manual-IV post-traumatic stress disorder (PTSD), major depressive episode (MDE), generalized anxiety disorder, social anxiety disorder (SAD), and alcohol abuse and dependence. Self-report health professional diagnoses were assessed for attention deficit hyperactivity disorder (ADHD), mania, obsessive compulsive disorder (OCD), and personality disorder. We established weighted prevalence of mental disorders and examined the association between mental disorders using logistic regression. Results: In 2018, lifetime prevalence of any WHO-CIDI-based or self-reported mental disorder was 58.1%. Lifetime prevalence of any mood or anxiety disorder or PTSD was 54.0% in 2018. MDE (39.9%), SAD (25.7%), and PTSD (21.4%) were the most common mental disorders. There was a substantial increase in new onset or recurrence/persistence of mental disorders between the two measurement points (16-year assessment gap); 2002–2018 period prevalences were 43.5% for mood and anxiety disorder and 16.8% for alcohol abuse or dependence. The prevalence of self-reported ADHD, OCD, any personality disorder, and mania were 3.3%, 3.0%, 0.8%, and 0.8%, respectively. Comorbidity between mental disorders increased over the follow-up. Conclusions: This study demonstrates a high burden of mental disorders among a large Canadian military and veteran cohort. These findings underscore the importance of prevention and intervention strategies to reduce the burden of mental disorders and alcohol use disorders in these populations.

Well-being of Canadian Veterans during the COVID-19 pandemic: cross-sectional results from the COVID-19 Veteran well-being study

“…Our reported rates of probable PTSD and probable MDD rates were higher than previously reported norms (34% and 35%, respectively, compared to 15% and 18% in 2013) (Richardson et al, 2014 ; Thériault et al, 2020 ). However, findings are consistent with similarly high rates of lifetime prevalence for mental health conditions self-reported in the CAF Members and Veterans Mental Health Follow-up Survey (Sareen et al, 2021 ). These rates, in part, may be attributable to the negative impact of social isolation on the already-vulnerable population of Veterans with high prevalence of mental health conditions.…”

Examining Neuroendocrine and Inflammatory Biomarker Profiles to Characterize PTSD Subtypes and Symptom Profiles.

“…In the current study, individuals with a PTSD diagnosis displayed significantly elevated depressive symptoms compared to healthy controls. This is certainly in line with previous reports revealing that among those with a diagnosis of PTSD, 79.6% will also experience a major depressive episode in their lifetime (Sareen et al, 2021). Additionally, it was found that individuals with the dissociative PTSD subtype displayed elevated negative affect and depression scores, with a mean BDI score that met the cut-off for severe depression, compared to individuals with non-dissociative PTSD.…”

“…Due to the elevated levels of trauma experienced, veterans and military personnel are at risk of not only developing PTSD, but also co-occurring mental disorders. In line with this suggestion, of the veterans with a PTSD diagnosis, approximately 80% also had major depressive episodes, 46% had a generalized anxiety disorder, 51% had a panic disorder, and 59% had a social anxiety disorder (Sareen et al, 2021). These findings suggest that over time, mental disorders may accumulate, even long after the exposure to trauma.…”

Are first responders interested in psychedelics? Assessing previous use, interest, and willingness to participate in psychedelic-assisted therapy

“…First responders, such as firefighters, police officers, and paramedics, are often exposed to potentially traumatic events as part of their occupation. As a result, they experience higher rates of mental and physical health issues compared to the general population (Fullerton, Ursano, & Wang, 2004;Hourani et al, 2020;Jones, 2017;Pedersen, Ugelvig Petersen, Ebbehøj, Bonde, & Hansen, 2018;Sareen et al, 2021;Wright et al, 2021). Notably, first responders are at an increased risk of post-traumatic stress disorder (PTSD), which often co-occurs with depressive symptoms, suicidal thoughts, and related behaviours (Jones, 2017;Lewis-Schroeder et al, 2018;Stanley, Hom, & Joiner, 2016).…”