What are the effects of having an illness or injury whilst deployed on post deployment mental health? A population based record linkage study of UK Army personnel who have served in Iraq or Afghanistan

Abstract

BackgroundThe negative impact of sustaining an injury on a military deployment on subsequent mental health is well-documented, however, the relationship between having an illness on a military operation and subsequent mental health is unknown.MethodsPopulation based study, linking routinely collected data of attendances at emergency departments in military hospitals in Iraq and Afghanistan [Operational Emergency Department Attendance Register (OpEDAR)], with data on 3896 UK Army personnel who participated in a military health study between 2007 and 2009 and deployed to Iraq or Afghanistan between 2003 to 2009.ResultsIn total, 13.8% (531/3896) of participants had an event recorded on OpEDAR during deployment; 2.3% (89/3884) were medically evacuated. As expected, those medically evacuated for an injury were at increased risk of post deployment probable PTSD (odds ratio 4.27, 95% confidence interval 1.80-10.12). Less expected was that being medically evacuated for an illness was also associated with a similarly increased risk of probable PTSD (4.39, 1.60-12.07) and common mental disorders (2.79, 1.41-5.51). There was no association between having an OpEDAR event and alcohol misuse. Having an injury caused by hostile action was associated with increased risk of probable PTSD compared to those with a non-hostile injury (3.88, 1.15 to 13.06).ConclusionsPersonnel sustaining illnesses on deployment are just as, if not more, at risk of having subsequent mental health problems as personnel who have sustained an injury. Monitoring of mental health problems should consider those with illnesses as well as physical injuries.

Treatment of Mental or Physical Health Problems in a Combat Zone: Comparisons of Postdeployment Mental Health and Early Separation From Service

“…The TMHED adjusted OR was higher than that of Forbes et al. (; OR = 1.54) for postdeployment mental health problems among United Kingdom Army personnel who had any type of illness/injury while deployed. These rates are consistent with available evidence that health problems during deployment are associated with a higher risk of postdeployment mental health problems, but the effect was particularly pronounced for mental disorders in this study.…”

“…Still, some personnel are at higher risk for postdeployment adjustment problems than others. A recent study showed that rates of postdeployment mental problems were higher for personnel who were injured or ill while deployed than for those who remained healthy (Forbes et al, 2012). Given that illness and injury are associated with increased risk of postdeployment mental disorders (DiMatteo, 2004;Koren, Norman, Cohen, Berman, & Klein, 2005), an increased risk also seems likely among personnel treated in theater for mental health problems.…”

“…The comparison of postdeployment adjustment rates of these groups provided the opportunity to assess whether associated risks for in-theater mental health treatment and postdeployment adjustment were unique or simply an expression of general health problems in theater (Forbes et al, 2012). Our hypotheses were that (a) the risk of postdeployment problems would be higher for personnel who had health problems-mental or physical-while deployed compared with the general deployed group, and (b) the risk of postdeployment problems would be higher for those with mental health problems than for those with physical health problems in theater.…”

Informal caregiving and intimate relationships: the experiences of spouses of UK military personnel

“…The consequences of injuries are pertinent for military personnel, and for their families who frequently provide informal care during the recuperation process 1 2. The healthy partner often assumes the role of primary caregiver and takes on greater responsibility for household tasks, and for maintaining personal and social relationships, and social networks as seen in a study of wounded, injured or sick (WIS) US military personnel 3.…”

Health surveillance of deployed military personnel occasionally leads to unexpected findings

“…The high rates of post-traumatic stress disorder (PTSD) found by Forbes et al [1] in personnel medically evacuated from Iran and Afghanistan while on deployment is surprising. Those military personnel who were medically ill had similar rates of PTSD as those evacuated for injuries sustained in combat.…”