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Abstract

Objective:

This cross-sectional study investigated the relationship between psychiatric diagnosis and impaired work functioning among American service members returning from Operation Iraqi Freedom-Operation Enduring Freedom (OEF-OIF).

Methods:

Participants were 797 OEF-OIF veterans, of whom 473 were employed. They were referred for further psychiatric assessment by primary care providers at six Veterans Affairs medical centers and underwent a behavioral health interview that assessed psychiatric and health status and work impairment as measured by the Work Limitations Questionnaire (WLQ). The four WLQ subscales (mental-interpersonal demands, time management, output, and physical demands) and an aggregated measure of productivity loss were considered in the analysis. Associations between patient characteristics, psychiatric status, and work impairments were investigated with regression models.

Results:

Major depressive disorder, posttraumatic stress disorder, and generalized anxiety or panic disorder were significantly associated with impairments in mental-interpersonal demands, time management, and output. Alcohol dependence and illicit drug use were associated with impairments in output and physical demands. On average these productivity losses were four times those found in a previous study of nonveteran employees with no psychiatric disorders.

Conclusions:

Veterans' ability to maintain gainful employment is a major component of successful reintegration into civilian life, and psychiatric disorders have a negative impact on work performance. This study demonstrated that multiple dimensions of job performance are impaired by psychiatric illness among OEF-OIF veterans. Delivery of empirically supported interventions to treat psychiatric disorders and development of care models that focus on work-specific interventions are needed to help veterans return to civilian life. (Psychiatric Services 62:39–46, 2011)

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Figures and Tables

Table 1 Characteristics and behavioral health assessment outcomes of 797 veterans of Operations Enduring Freedom and Iraqi Freedom, by employment status
Table 2 Linear regression analyses of potential predictors of work impairment among 468 employed veterans of Operations Enduring Freedom and Iraqi Freedom, by Work Limitations Questionnaire subscale
Table 3 Linear regression analyses of potential predictors of productivity loss among 468 employed veterans of Operations Enduring Freedom and Iraqi Freedom

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: 39 - 46
PubMed: 21209298

History

Published in print: January 2011
Published online: 14 January 2015

Authors

Details

David A. Adler, M.D.
Dr. Adler, Dr. Lerner, and Dr. Chang are affiliated with the Departments of Medicine and Psychiatry, Tufts Medical Center, Boston.
Kyle Possemato, Ph.D.
Dr. Possemato is with the Center for Integrated Healthcare, Syracuse Department of Veterans Affairs (VA) Medical Center, and the Department of Psychology, Syracuse University, Syracuse, New York.
Shahrzad Mavandadi, Ph.D.
Dr. Mavandadi, Dr. Klaus, and Ms. Ingram are with the Philadelphia VA Medical Center and the Department of Psychiatry, University of Pennsylvania, Philadelphia.
Debra Lerner, M.S., Ph.D.
Dr. Adler, Dr. Lerner, and Dr. Chang are affiliated with the Departments of Medicine and Psychiatry, Tufts Medical Center, Boston.
Hong Chang, Ph.D.
Dr. Adler, Dr. Lerner, and Dr. Chang are affiliated with the Departments of Medicine and Psychiatry, Tufts Medical Center, Boston.
Johanna Klaus, Ph.D.
Dr. Mavandadi, Dr. Klaus, and Ms. Ingram are with the Philadelphia VA Medical Center and the Department of Psychiatry, University of Pennsylvania, Philadelphia.
James D. Tew, M.D.
Dr. Tew is with the Pittsburgh VA Medical Center, and the Department of Psychiatry, University of Pittsburgh School of Medicine.
David Barrett, M.D.
Dr. Barrett is with the Department of Psychiatry, University of Maryland, and the VA Maryland Health Care System, Baltimore.
Erin Ingram, B.A.
Dr. Mavandadi, Dr. Klaus, and Ms. Ingram are with the Philadelphia VA Medical Center and the Department of Psychiatry, University of Pennsylvania, Philadelphia.

Notes

Send correspondence to Dr. Oslin, who is with the Philadelphia VA Medical Center and the Department of Psychiatry, University of Pennsylvania, 3900 Chestnut St., Philadelphia, PA 11104 (e-mail: [email protected]).

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