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BMC Psychiatry
Published in: BMC Psychiatry 1/2012

Open Access 01-12-2012 | Research article

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

Authors: Harriet J Forbes, Norman Jones, Charlotte Woodhead, Neil Greenberg, Kate Harrison, Sandra White, Simon Wessely, Nicola T Fear

Published in: BMC Psychiatry | Issue 1/2012

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Abstract

Background

The 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.

Methods

Population 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.

Results

In 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).

Conclusions

Personnel 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.
Appendix
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Literature
1.
Russell R, Hodgetts T, Ollerton J, Massetti P, Skeet J, Bray I, Harrison K: The operational emergency department attendance register (OPEDAR): a new epidemiological tool. J R Army Med Corps. 2007, 153: 244-250.CrossRefPubMed
2.
3.
4.
Sanders JW, Putnam SD, Frankart C, Frenck RW, Monteville MR, Riddle MS, Rockabrand DM, Sharp TW, Tribble DR: Impact of illness and non-combat injury during operations Iraqi freedom and enduring freedom (Afghanistan). AmJTrop Med Hyg. 2005, 73: 713-719.
5.
Cohen SP, Brown C, Kurihara C, Plunkett A, Nguyen C, Strassels SA: Diagnoses and factors associated with medical evacuation and return to duty for service members participating in Operation Iraqi Freedom or Operation Enduring Freedom: a prospective cohort study. Lancet. 2010, 375: 301-309. 10.1016/S0140-6736(09)61797-9.CrossRefPubMed
6.
Hoge CW, Castro CA, Messer SC, McGurk D, Cotting DI, Koffman RL: Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. N Engl J Med. 2004, 351: 13-22. 10.1056/NEJMoa040603.CrossRefPubMed
7.
Blanchard EB, Hickling EJ, Taylor AE, Loos W: Psychiatric morbidity associated with motor vehicle accidents. J Nerv Ment Dis. 1995, 183: 495-504. 10.1097/00005053-199508000-00001.CrossRefPubMed
8.
Helzer JE, Robins LN, McEvoy L: Post-traumatic stress disorder in the general population. Findings of the epidemiologic catchment area survey. N Engl J Med. 1987, 317: 1630-1634. 10.1056/NEJM198712243172604.CrossRefPubMed
9.
10.
Fear NT, Jones M, Murphy D, Hull L, Iversen AC, Coker B, Machell L, Sundin J, Woodhead C, Jones N, et al: What are the consequences of deployment to Iraq and Afghanistan on the mental health of the UK armed forces? A cohort study. Lancet. 2010, 375: 1783-1797. 10.1016/S0140-6736(10)60672-1.CrossRefPubMed
11.
Hotopf M, Hull L, Fear NT, Browne T, Horn O, Iversen A, Jones M, Murphy D, Bland D, Earnshaw M, et al: The health of UK military personnel who deployed to the 2003 Iraq war: a cohort study. Lancet. 2006, 367: 1731-1741. 10.1016/S0140-6736(06)68662-5.CrossRefPubMed
12.
Blanchard EB, JonesAlexander J, Buckley TC, Forneris CA: Psychometric properties of the PTSD checklist (PCL). Behav Res Ther. 1996, 34: 669-673. 10.1016/0005-7967(96)00033-2.CrossRefPubMed
13.
Goldberg DP, Gater R, Sartorius N, Ustun TB, Piccinelli M, Gureje O, Rutter C: The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychol Med. 1997, 27: 191-197. 10.1017/S0033291796004242.CrossRefPubMed
14.
Babor TF H-BJ, Saunders JB, Monteiro MG: AUDIT. The Alcohol Use Disorders Identification Test. 2001, World Health Organisation, Geneva, 2
15.
Fear NT, Iversen A, Meltzer H, Workman L, Hull L, Greenberg N, Barker C, Browne T, Earnshaw M, Horn O, et al: Patterns of drinking in the UK Armed Forces. Addiction. 2007, 102: 1749-1759. 10.1111/j.1360-0443.2007.01978.x.CrossRefPubMed
16.
Ware JE, Sherbourne CD: The Mos 36-item short-form health survey (Sf-36) .1. Conceptual-framework and item selection. Medical Care. 1992, 30: 473-483. 10.1097/00005650-199206000-00002.CrossRefPubMed
17.
Tuck JJ, Bricknell MC: A review of 10 years of systematic health surveillance in the Army. J R Army Med Corps. 2005, 151: 163-170.CrossRefPubMed
18.
Browne T, Hull L, Horn O, Jones M, Murphy D, Fear NT, Greenberg N, French C, Rona RJ, Wessely S, Hotopf M: Explanations for the increase in mental health problems in UK reserve forces who have served in Iraq. Br J Psychiatry. 2007, 190: 484-489. 10.1192/bjp.bp.106.030544.CrossRefPubMed
19.
Koren D, Norman D, Cohen A, Berman J, Klein EM: Increased PTSD risk with combat-related injury: A matched comparison study of injured and uninjured soldiers experiencing the same combat events. Am J Psychiatry. 2005, 162: 276-282. 10.1176/appi.ajp.162.2.276.CrossRefPubMed
20.
MacGregor AJ, Shaffer RA, Dougherty AL, Galarneau MR, Raman R, Baker DG, Lindsay SP, Golomb BA, Corson KS: Psychological correlates of battle and nonbattle injury among operation Iraqi freedom veterans. Mil Med. 2009, 174: 224-231.CrossRefPubMed
21.
Tedstone JE, Tarrier N: Posttraumatic stress disorder following medical illness and treatment. Clin Psychol Rev. 2003, 23: 409-448. 10.1016/S0272-7358(03)00031-X.CrossRefPubMed
22.
Griffiths J, Fortune G, Barber V, Young JD: The prevalence of post traumatic stress disorder in survivors of ICU treatment: a systematic review. Intensive Care Med. 2007, 33: 1506-1518. 10.1007/s00134-007-0730-z.CrossRefPubMed
23.
24.
Jones N, Fear NT, Jones M, Wessely S, Greenberg N: Long-term military work outcomes in soldiers who become mental health casualties when deployed on operations. Psychiatry. 2010, 73: 352-364.CrossRefPubMed
25.
Wilk JE, Bliese PD, Kim PY, Thomas JL, McGurk D, Hoge CW: Relationship of combat experiences to alcohol misuse among U.S. soldiers returning from the Iraq war. Drug Alcohol Depend. 2010, 108: 115-121. 10.1016/j.drugalcdep.2009.12.003.CrossRefPubMed
26.
Rona RJ, Jones M, Fear NT, Hull L, Murphy D, Machell L, Coker B, Iversen AC, Jones N, David AS, et al: Mild traumatic brain injury in UK military personnel returning from Afghanistan and Iraq: Cohort and cross-sectional analyses. J Head Trauma Rehabil. 2012, 33–44: 33-44.CrossRef
27.
Mulligan K, Jones N, Woodhead C, Davies M, Wessely S, Greenberg N: Mental health of UK military personnel while on deployment in Iraq. Br J Psychiatry. 2010, 197: 405-410. 10.1192/bjp.bp.110.077263.CrossRefPubMed
Metadata
Title
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
Authors
Harriet J Forbes
Norman Jones
Charlotte Woodhead
Neil Greenberg
Kate Harrison
Sandra White
Simon Wessely
Nicola T Fear
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2012
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/1471-244X-12-178

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