Crystal Phen reports in Med Page today (January 16, 2008) that ”posttraumatic stress disorder (PTSD) was three times more common among troops involved in combat in Iraq or Afghanistan than among those not so exposed.”
Not so surprisingly, Tyler C. Smith, Ph.D. of the Naval Health Research center found in a prospective population-based cohort study, that combat exposure for individuals serving in the Army or Air Force increased the likelihood of PTSD. It was also found that the odds for PTSD more than doubled for those exposed to combat in the Navy or Coast Guard and Marines.
In one recent study, the rate of PTSD was 11.8% among regular forces and 12.7%
among reserves at screening immediately after deployment, whereas it jumped to
16.7% and 24.5%, respectively, six months later. (See: Mental Health Problems of Iraq Veterans May Be Delayed)
To get prospective rates, the researchers analyzed health outcomes from 50,184 participants surveyed in the 22-year longitudinal Millennium Cohort Study.
The cohort included active military duty and reserve or National Guard personnel surveyed at baseline from July 2001 to June 2003 before the wars in Iraq and Afghanistan and again an average of 2.8 years later.
The rates of new onset self-reported symptoms were:
7.6% among those deployed with self-reported combat exposures.
1.4% among those deployed without self-reported combat exposures.
2.3% among those not deployed.
In a nutshell, the studies are showing that specific combat exposures are the problem, and that deployment (itself) does not significantly affect the onset of PTSD.
The article also listed characteristics of individuals who are at higher risk of PTSD: being female, divorced, younger, less educated, black, reserve or National Guard member, health care specialist, a self reported smoker or a problem drinker. Furthermore, persistent PTSD symptoms were found to be more common among those who were older, higher educated, divorced, smokers, drinkers, health care specialists, reservist, or national guard members.
Although the overall prevalence was not high, especially compared with the up to 30% rate among veterans of the war in Vietnam, it still represents a substantial number of cases because of the number of military members exposed to combat over time in Iraq and Afghanistan, the researchers said.
Particularly in these wars, they added, “the unpredictability and intensity of urban combat, constant risk of roadside bombs, multiple and prolonged tours, and complex problems of differentiating enemies from allies can leave many troops with high stress levels and possible lasting health consequences.”
While the risk conferred by combat exposure may not be preventable, they concluded, special attention might need to be paid to the more vulnerable subsets of the military populations.