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Trends and risk factors for mental health diagnoses among Iraq and Afghanistan veterans using department of Veterans Affairs Health Care, 2002-2008

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  • Seal, K.H.
  • Metzler, T.J.
  • Gima, K.S.
  • Bertenthal, D.
  • Maguen, S.
  • Marmar, C.R.

Abstract

Objectives. We sought to investigate longitudinal trends and risk factors for mental health diagnoses among Iraq and Afghanistan veterans. Methods. We determined the prevalence and predictors of mental health diagnoses among 289 328 Iraq and Afghanistan veterans entering Veterans Affairs (VA) health care from 2002 to 2008 using national VA data. Results. Of 289 328 Iraq and Afghanistan veterans, 106 726 (36.9%) received mental health diagnoses; 62 929 (21.8%) were diagnosed with posttraumatic stress disorder (PTSD) and 50 432 (17.4%) with depression. Adjusted 2-year prevalence rates of PTSD increased 4 to 7 times after the invasion of Iraq. Active duty veterans younger than 25 years had higher rates of PTSD and alcohol and drug use disorder diagnoses compared with active duty veterans older than 40 years (adjusted relative risk=2.0 and 4.9, respectively). Women were at higher risk for depression than were men, but men had over twice the risk for drug use disorders. Greater combat exposure was associated with higher risk for PTSD. Conclusions. Mental health diagnoses increased substantially after the start of the Iraq War among specific subgroups of returned veterans entering VA health care. Early targeted interventions may prevent chronic mental illness.

Suggested Citation

  • Seal, K.H. & Metzler, T.J. & Gima, K.S. & Bertenthal, D. & Maguen, S. & Marmar, C.R., 2009. "Trends and risk factors for mental health diagnoses among Iraq and Afghanistan veterans using department of Veterans Affairs Health Care, 2002-2008," American Journal of Public Health, American Public Health Association, vol. 99(9), pages 1651-1658.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2008.150284_4
    DOI: 10.2105/AJPH.2008.150284
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    Cited by:

    1. Mattocks, Kristin M. & Haskell, Sally G. & Krebs, Erin E. & Justice, Amy C. & Yano, Elizabeth M. & Brandt, Cynthia, 2012. "Women at war: Understanding how women veterans cope with combat and military sexual trauma," Social Science & Medicine, Elsevier, vol. 74(4), pages 537-545.
    2. Rui Zhen & Xiao Zhou & Xinchun Wu, 2019. "Patterns of Posttraumatic Stress Disorder and Depression Among Adolescents Following an Earthquake: a Latent Profile Analysis," Child Indicators Research, Springer;The International Society of Child Indicators (ISCI), vol. 12(6), pages 2173-2187, December.
    3. Nicholas J. Beutell & Marianne M. O’Hare & Joy A. Schneer & Jeffrey W. Alstete, 2017. "Coping with Fear of and Exposure to Terrorism among Expatriates," IJERPH, MDPI, vol. 14(7), pages 1-13, July.
    4. Ming-Ching Hsu, 2023. "The Construction of Critical Factors for Successfully Introducing Chatbots into Mental Health Services in the Army: Using a Hybrid MCDM Approach," Sustainability, MDPI, vol. 15(10), pages 1-22, May.
    5. Asghar Afshar Jahanshahi & Alexander Brem & Hussain Gholami, 2019. "Working in a Physically Dangerous Work Environment: Employee Vitality and Sustainable Behavior," Sustainability, MDPI, vol. 11(19), pages 1-20, September.
    6. Ryan D. Edwards, 2010. "A Review of War Costs in Iraq and Afghanistan," NBER Working Papers 16163, National Bureau of Economic Research, Inc.
    7. Randall Nedegaard & Jana Zwilling, 2017. "Promoting Military Cultural Competence among Civilian Care Providers: Learning through Program Development," Social Sciences, MDPI, vol. 6(1), pages 1-11, February.
    8. Sean Cowlishaw & Isabella Freijah & Dzenana Kartal & Alyssa Sbisa & Ashlee Mulligan & MaryAnn Notarianni & Anne-Laure Couineau & David Forbes & Meaghan O’Donnell & Andrea Phelps & Katherine M. Iverson, 2022. "Intimate Partner Violence (IPV) in Military and Veteran Populations: A Systematic Review of Population-Based Surveys and Population Screening Studies," IJERPH, MDPI, vol. 19(14), pages 1-23, July.

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