What are the consequences of deployment to Iraq and Afghanistan on the mental health of the UK armed forces? A cohort study

The Lancet

Volumn 375, Issue 9728, 2010, Pages 1783-1797

  Fear, Nicola T ^a   Jones, Margaret ^a   Murphy, Dominic ^a   Hull, Lisa ^a   Iversen, Amy C ^a   Coker, Bolaji ^a   Machell, Louise ^a   Sundin, Josefin ^a   Woodhead, Charlotte ^a   Jones, Norman ^a   Greenberg, Neil ^a   Landau, Sabine ^a   Dandeker, Christopher ^a   Rona, Roberto J ^a   Hotopf, Matthew ^a   Wessely, Simon ^a  

^a KING'S COLLEGE LONDON   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; AFGHANISTAN; ALCOHOL ABUSE; ARMY; ARTICLE; COHORT ANALYSIS; CONTROLLED STUDY; FEMALE; HEALTH SURVEY; HIGH RISK POPULATION; HUMAN; IRAQ; MAJOR CLINICAL STUDY; MALE; MENTAL DISEASE; MENTAL HEALTH; MILITARY DEPLOYMENT; POSTTRAUMATIC STRESS DISORDER; PREVALENCE; PRIORITY JOURNAL; PSYCHOLOGIC ASSESSMENT; SOLDIER; UNITED KINGDOM;

EID: 77952546853     PISSN: 01406736     EISSN: None     Source Type: Journal    
DOI: 10.1016/S0140-6736(10)60672-1     Document Type: Article

References (55)

1. Hotopf M., Hull L., Fear N.T., et al. The health of UK military personnel who deployed to the 2003 Iraq war: a cohort study. Lancet 367 (2006) 1731-1741
2. Hoge C.W., Castro C.A., Messer S.C., McGurk D., Cotting D.I., and Koffman R.L. Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. N Engl J Med 351 (2004) 13-22
3. Health Program Analysis & Evaluation. 2003-2004 active duty health study. Revised by Health Program Analysis & Evaluation. TRICARE Management Activity: Falls Church, 2006.
4. Schell T., and Marshall G. Survey of individuals previously deployed for OEF/OIF. In: Tanielian T., and Jaycox J. (Eds). Invisible wounds of war: psychological and cognitive injuries, their consequences, and services to assist recovery (2008), RAND Corporation, Washington DC
5. Sundin J., Fear N.T., Iversen A., Rona R.J., and Wessely S. PTSD after deployment to Iraq: conflicting rates, conflicting claims. Psychol Med 40 (2010) 367-382
6. Bliese P.D., Wright K.M., Adler A.B., Thomas J.L., and Hoge C.W. Timing of postcombat mental health assessments. Psychol Serv 4 (2007) 141-148
7. Cabrera O.A., Hoge C.W., Bliese P.D., Castro C.A., and Messer S.C. Childhood adversity and combat as predictors of depression and post-traumatic stress in deployed troops. Am J Prev Med 33 (2007) 77-82
8. Duma S.J., Reger M.A., Canning S.S., McNeil J.D., and Gahm G.A. Longitudinal mental health screening results among postdeployed U.S. soldiers preparing to deploy again. J Trauma Stress 23 (2010) 52-58
9. Hoge C.W., Terhakopian A., Castro C.A., Messer S.C., and Engel C.C. Association of posttraumatic stress disorder with somatic symptoms, health care visits, and absenteeism among Iraq war veterans. Am J Psychiatry 164 (2007) 150-153
10. Milliken C.S., Auchterlonie J.L., and Hoge C.W. Longitudinal assessment of mental health problems among active and reserve component soldiers returning from the Iraq war. J Am Med Assoc 298 (2007) 2141-2148
11. Vasterling J.J., Proctor S.P., Friedman M.J., et al. PTSD symptom increases in Iraq-deployed soldiers: comparison with nondeployed soldiers and associations with baseline symptoms, deployment experiences, and postdeployment stress. J Trauma Stress 23 (2010) 41-51
12. Ministry of Defence. Operations in Afghanistan. http://www.mod.uk/DefenceInternet/DefenceNews/InDepth/OperationsInAfghan istan.htm (accessed April 28, 2010).
13. Smith M. Scores of troops traumatised by Afghan war. The Sunday Times (April 26, 2009). http://www.timesonline.co.uk/tol/news/politics/article6168982.ece (accessed April 22, 2010).
14. Reger M.A., Gahm G.A., Swanson R.D., and Duma S.J. Association between number of deployments to Iraq and mental health screening outcomes in US Army soldiers. J Clin Psychiatry 70 (2009) 1266-1272
15. Office of the Command Surgeon US Forces Afghanistan (USFOR-A) and Office of The Surgeon General United States Army Medical Command. Mental Health Advisory Team (MHAT) 6. Operation Enduring Freedom 2009 Afghanistan (Nov 6, 2009). http://www.armymedicine.army.mil/reports/mhat/mhat_vi/MHAT_VI-OEF_EXSUM. pdf (accessed April 23, 2010).
16. Tate A.R., Jones M., Hull L., et al. How many mailouts?. BMC Med Res Methodol 7 (2007) 51
17. DASA. UK Defence Statistics 2009. http://www.dasa.mod.uk/modintranet/UKDS/UKDS2009/ukds.html?PublishTime=0 9:30:00 (accessed Feb 16, 2010).
18. DASA. TSP 7-UK Reserves and Cadets Strengths (November, 2009). http://www.dasa.mod.uk/applications/newWeb/www/index.php?page=48&pub Type=1&thiscontent=70&PublishTime=09:30:00&date=2009-11-23 &disText=01%20Apr%202009&from=listing&topDate=2009-11-23 (accessed Feb 16, 2010).
19. Ware Jr. J.E., and Sherbourne C.D. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30 (1992) 473-483
20. McHorney C.A., Ware Jr. J.E., and Raczek A.E. The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 31 (1993) 247-263
21. Goldberg D.P., Gater R., Sartorius N., et al. The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychol Med 27 (1997) 191-197
22. Weathers F., Litz B., Herman D., Huska J., and Keane T. The PTSD checklist-civilian version (PCL-C) (1994), National Centre for PTSD, Boston
23. Babor T.F., Higgins-Biddle J.C., Saunders J.B., and Monteiro M.G. AUDIT. The Alcohol Use Disorders Identification Test (2001), Department of Mental Health and Substance Dependence, WHO, Geneva
24. Fear N.T., Iversen A., Meltzer H., et al. Patterns of drinking in the UK Armed Forces. Addiction 102 (2007) 1749-1759
25. Chalder T., Berelowitz G., Pawlikowska T., et al. Development of a fatigue scale. J Psychosom Res 37 (1993) 147-153
26. Ministry of Defence. Operations in Iraq. http://www.mod.uk/DefenceInternet/DefenceNews/InDepth/UkMilitaryOperatio nsInIraq.htm (accessed April 28, 2010).
27. BBC. UK fatalities in Afghanistan and Iraq. http://news.bbc.co.uk/1/hi/uk/8260060.stm (accessed April 28, 2010).
28. Rona R.J., Fear N.T., Hull L., et al. Mental health consequences of overstretch in the UK armed forces: first phase of a cohort study. BMJ 335 (2007) 603
29. Wilson J., Jones M., Fear N.T., et al. Is previous psychological health associated with the likelihood of Iraq War deployment? An investigation of the "healthy warrior effect". Am J Epidemiol 169 (2009) 1362-1369
30. Hickley M. British troops back from Afghanistan are 10 times more likely to suffer mental illness, say MOD. Mail Online (Nov 5, 2008). http://www.dailymail.co.uk/health/article-1082991/British-troops-Afghani stan-10-times-likely-suffer-mental-illness-say-MOD.html#ixzz0mKwIznzR (accessed April 27, 2010).
31. BBC Radio 4. Transcript of "file on 4": military post traumatic stress disorder (November, 2008). http://news.bbc.co.uk/1/shared/bsp/hi/pdfs/04_11_08_fo4_ptsd.pdf (accessed April 27, 2010).
32. BBC News Online. Veteran mental care 'a disgrace' (February, 2009). http://news.bbc.co.uk/1/hi/uk/7916221.stm (accessed April 27, 2010).
33. Browne T., Iversen A., Hull L., et al. How do experiences in Iraq affect alcohol use among male UK armed forces personnel?. Occup Environ Med 65 (2008) 628-633
34. Hooper R., Rona R.J., Jones M., Fear N.T., Hull L., and Wessely S. Cigarette and alcohol use in the UK Armed Forces, and their association with combat exposures: a prospective study. Addict Behav 33 (2008) 1067-1071
35. Jacobson I.G., Ryan M., Hooper T.I., et al. Alcohol use and alcohol-related problems before and after military combat deployment. J Am Med Assoc 300 (2008) 663-675
36. Wilk J.E., Bliese P.D., Kim P.Y., Thomas J.L., McGurk D., and Hoge C.W. Relationship of combat experiences to alcohol misuse among U.S. soldiers returning from the Iraq war. Drug Alcohol Depend 108 (2010) 115-121
37. Jones E., and Wessely S. Psychiatric battle casualties: an intra- and inter-war comparison. Br J Psychiatry 178 (2001) 242-247
38. Maguen S., Lucenko B.A., Reger M.A., et al. The impact of reported direct and indirect killing on mental health symptoms in Iraq war veterans. J Trauma Stress 23 (2010) 86-90
39. Browne T., Hull L., Horn O., et al. Explanations for the increase in mental health problems in UK reserve forces who have served in Iraq. Br J Psychiatry 190 (2007) 484-489
40. McManus S., Meltzer H., Brugha T., Bebbington P., and Jenkins R. Adult psychiatric morbidity in England, 2007: results of a household survey (2009), NHS Information Centre for health and social care, Leeds. http://www.ic.nhs.uk/webfiles/publications/mental%20health/other%20menta l%20health%20publications/Adult%20psychiatric%20morbidity%2007/APMS%2007 %20%28FINAL%29%20Standard.pdf (accessed Feb 17, 2010).
41. Hotopf M., and Wessely S. Can epidemiology clear the fog of war? Lessons from the first Gulf War. Int J Epidemiol 34 (2005) 791-800
42. National Audit Office. Ministry of Defence. Recruitment and retention in the armed forces. Report by the Controller and Auditor General; HC 1633-I session 2005-06 (Nov 3, 2006). http://www.nao.org.uk/publications/0506/recruitment_and_retention_in_t.a spx (accessed May 4, 2010).
43. National Collaborating Centre for Mental Health commissioned by the National Institute for Clinical Excellence. Post-traumatic stress disorder. The management of PTSD in adults and children in primary and secondary care. National Clinical Practice Guideline Number 26. The Royal College of Psychiatrists and The British Psychological Society (2005). http://www.nice.org.uk/nicemedia/pdf/CG026fullguideline.pdf (accessed Feb 17, 2010).
44. Andrews B., Brewin C.R., Stewart L., Philpott R., and Hejdenberg J. Comparison of immediate-onset and delayed-onset posttraumatic stress disorder in military veterans. J Abnorm Psychol 118 (2009) 767-777
45. Solomon Z., and Mikulincer M. Trajectories of PTSD: a 20-year longitudinal study. Am J Psychiatry 163 (2006) 659-666
46. Rona R.J., Hooper R., Jones M., et al. Mental health screening in armed forces before the Iraq war and prevention of subsequent psychological morbidity: follow-up study. BMJ 333 (2006) 991-996
47. Department of Veteran's Affairs. Federal benefits for veterans, dependents and survivors. 2010 edn. (2010), Department of Veteran's Affairs, Washington DC. http://www1.va.gov/opa/publications/benefits_book.asp (accessed April 24, 2010).
48. Unwin C., Blatchley N., Coker W., et al. Health of UK servicemen who served in Persian Gulf War. Lancet 353 (1999) 169-178
49. Iversen A., Liddell K., Fear N., Hotopf M., and Wessely S. Consent, confidentiality, and the Data Protection Act. BMJ 332 (2006) 165-169
50. Groves R.M. Nonresponse rates and nonresponse bias in household surveys. Pub Opin Quart 70 (2006) 646-675
51. Smith T.C., Ryan M., Wingard D.L., Slymen D.J., Sallis J.F., Kritz-Silverstein D., and for the Millennium Cohort Study Team. New onset and persistent symptoms of post-traumatic stress disorder self reported after deployment and combat exposures: prospective population based US military cohort study. BMJ 336 (2008) 366-371
52. Dohrenwend B.P., Turner J.B., Turse N.A., Adams B.G., Koenen K.C., and Marshall R. The psychological risks of Vietnam for U.S. veterans: a revisit with new data and methods. Science 313 (2006) 979-982
53. Kulka R.A., Schlenger W.E., Fairbanks J.A., et al. Trauma and the Vietnam war generation: report of findings from the National Vietnam Veterans Readjustment Study (1990), Brunner Mazel Publishers, New York
54. Frueh B.C., Elhai J.D., Grubaugh A.L., et al. Documented combat exposure of US veterans seeking treatment for combat-related post-traumatic stress disorder. Br J Psychiatry 186 (2005) 467-472
55. Rothman K.J. No adjustments are needed for multiple comparisons. Epidemiology 1 (1990) 43-46