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Abstract

Objective:

This purpose of this study was to determine the incidence and types of preexisting mental disorders among military personnel who received mental health services in an Iraqi war zone.

Methods:

The study examined psychiatric histories of 1,078 American military personnel (Marines, 65%; Army, 23%; Navy, 11%; and Air Force, <1%) deployed to Iraq and seen by in-theater mental health providers between January 2006 and February 2007.

Results:

Among the 1,078 patients, the most frequent in-theater diagnoses were anxiety (24%), adjustment (23%), and mood (19%) disorders. Twenty-nine percent of the sample (N=308) had a psychiatric diagnosis in their medical records before their first encounter with mental health services in Iraq (Navy patients, 42%; Army patients, 39%; and Marine Corps patients, 23%). The mean time between last predeployment diagnosis and first in-theater mental health encounter was 21 months. For patients with a prior diagnosis, the highest rate of relapse (receipt of the same diagnosis in theater) was for attention-deficit hyperactivity disorder (57%), followed by anxiety disorders (44%)—especially posttraumatic stress disorder (PTSD) (55%)—mood disorders (38%), and adjustment disorders (32%).

Conclusions:

A significant proportion of military personnel who experienced mental health problems in a combat zone had preexisting psychiatric conditions. Because more than half of predeployment diagnoses were received in the nine months before the in-theater mental health encounter, further study may be advisable to determine whether a time-based algorithm for deployability is needed, particularly for PTSD, for which a high rate of repeat diagnosis in theater was found. (Psychiatric Services 62:15–21, 2011)

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Figures and Tables

Figure 1 Distribution in months of time intervals between the most recent predeployment psychiatric diagnosis and first in-theater psychiatric diagnosis
Table 1 Characteristics of 1,078 military personnel who received mental health services during deployment in Iraq, by service branch
Table 2 In-theater and predeployment psychiatric diagnoses among 1,078 military personnel who received mental health services in Iraq, by service branch
Table 3 In-theater psychiatric diagnoses among 1,078 military personnel who received mental health services in Iraq, by predeployment psychiatric diagnosis

Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Cover: View Across Frenchman's Bay From Mt. Desert Island, After a Squall, by Thomas Cole, 1845. Oil on canvas, 38 × 62 inches. Cincinnati Art Museum, gift of Alice Scarborough.
Psychiatric Services
Pages: 15 - 21
PubMed: 21209294

History

Published in print: January 2011
Published online: 15 October 2014

Authors

Details

Gerald E. Larson, Ph.D.
Dr. Larson and Ms. Schmied are affiliated with the Department of Behavioral Sciences and Epidemiology.
Paul S. Hammer, M.D., U.S.N.
Dr. Hammer, Dr. Webb-Murphy, and Ms. Schmitz are with the Center for Combat and Operational Stress Control, San Diego, California.
Terry L. Conway, Ph.D.
Dr. Conway, Mr. Galarneau, Dr. Konoske, and Mr. Edwards are with the Department of Medical Modeling, Simulation and Mission Support, all at the Naval Health Research Center, San Diego, California.
Emily A. Schmied, M.P.H.
Dr. Larson and Ms. Schmied are affiliated with the Department of Behavioral Sciences and Epidemiology.
Michael R. Galarneau, M.S.
Dr. Conway, Mr. Galarneau, Dr. Konoske, and Mr. Edwards are with the Department of Medical Modeling, Simulation and Mission Support, all at the Naval Health Research Center, San Diego, California.
Paula Konoske, Ph.D.
Dr. Conway, Mr. Galarneau, Dr. Konoske, and Mr. Edwards are with the Department of Medical Modeling, Simulation and Mission Support, all at the Naval Health Research Center, San Diego, California.
Jennifer A. Webb-Murphy, Ph.D.
Dr. Hammer, Dr. Webb-Murphy, and Ms. Schmitz are with the Center for Combat and Operational Stress Control, San Diego, California.
Kimberly J. Schmitz, M.S.
Dr. Hammer, Dr. Webb-Murphy, and Ms. Schmitz are with the Center for Combat and Operational Stress Control, San Diego, California.
Nathan Edwards, M.A.
Dr. Conway, Mr. Galarneau, Dr. Konoske, and Mr. Edwards are with the Department of Medical Modeling, Simulation and Mission Support, all at the Naval Health Research Center, San Diego, California.
Douglas C. Johnson, Ph.D.
Dr. Johnson is with the Department of Warfighter Performance.

Notes

Send correspondence to Ms. Schmied, Behavioral Sciences and Epidemiology, Dept. 163, 140 Sylvester Rd., San Diego CA 92106 (e-mail: [email protected]).

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