Am Jrl of Public Health: March Supplement 2012

The articles below will be published online Jan. 25, 2012, at 4 p.m. (ET) by the American Journal of Public Health® under “First Look” at http://www.ajph.org/first_look.shmtl, and they are currently scheduled to appear in the March Supplement 2012 print issue of the Journal. “First Look” articles have undergone peer review, copyediting and approval by authors but have not yet been printed to paper or posted online by issue. The American Journal of Public Health is published by the American Public Health Association, www.apha.org, and is available at www.ajph.org.

(1) Suicide rates among active duty military increased between 2005-2007

Suicide rates for all U.S. military services increased between 2005 and 2007, particularly for the regular Army and National Guard, reports a recent study published in the American Journal of Public Health.

Researchers investigated and identified risk factors for suicide among all active duty members of the U.S. military during 2005 and 2007. The study included the entire active duty U.S. military population, with a sample size of 2,064,183 for 2005 and 1,981,810 for 2007. They found that suicide rates for all services increased during this period. Mental health diagnoses, mental health visits, selective serotonin reuptake inhibitors, sleep prescriptions, reduction in rank, enlisted rank, and separation or divorce were associated with suicides. Deployments to Operation Enduring Freedom or Operation Iraqi Freedom were associated with elevated risk among all services in the 2007 population and for the Army in 2005.

Researchers speculated that the increased risk associated with deployments in 2007 compared with 2005 resulted from the extended duration of war and the increasing lengths of individual deployments for Army and Air Force personnel.

“Additional research needs to address the increasing rates of suicide in active duty personnel. This should include careful evaluation of suicide prevention programs and the possible increase in risk associated with SSRIs and other mental health drugs, as well as the possible impact of shorter deployments, age, mental health diagnoses, and relationship problems,” concluded the study’s authors.

[From: “Suicide Incidence and Risk Factors in an Active Duty United States Military Population.” ].

(2) Veterans returning from Iraq, Afghanistan experience elevated mental health and substance abuse risk; Army, Marine veterans fair worst

Veterans returning from war zone deployment in Iraq or Afghanistan are at higher risk for mental health problems and alcohol and drug abuse, reports a study published today in the American Journal of Public Health.

Researchers examined the mental and physical health, including posttraumatic stress symptoms, and alcohol and drug use, of a national sample of veterans within one year of returning from deployment in Afghanistan or Iraq. They also looked at differences by gender, service component (active, National Guard, other reserve), service branch (Army, Navy, Air Force, Marines) and deployment operation (Operation Enduring Freedom, Operation Iraqi Freedom). They surveyed a national sample of 596 veterans, oversampling women to make up 50 percent of the total, and National Guard and Reserve components to each make up 25 percent.

Researchers found that mental health functioning was significantly worse compared with the general population. Nearly 14 percent screened positive for probable post-traumatic stress disorder, 39 percent for probable alcohol abuse and 3 percent for probable drug abuse. Men reported more alcohol and drug use than did women, but there were no gender differences in post-traumatic stress disorder or other mental health domains. Operation Iraqi Freedom veterans reported more depression or functioning problems and alcohol and drug use than did Operation Enduring Freedom veterans. Army and Marine veterans reported worse mental and physical health than did Air Force or Navy veterans.

[From: "Mental and Physical Health Status and Alcohol and Drug Use Following Return From Deployment to Iraq or Afghanistan." ].

(3) Major depression and substance use disorders have increased among active duty combat-exposed veterans A new study from the American Journal of Public Health reports an increase in substance use disorders and major depression across military services associated with combat conditions.

Researchers analyzed the association between deployment characteristics and diagnostics rates for major depression and substance use disorder among active duty personnel. They looked at 678,382 active personnel serving between 2001 and 2006, and used deployment information from the Contingent Tracking System to identify individuals diagnosed with substance use disorders and major depression from TRICARE health records. They found an increased likelihood of diagnosis with both conditions to be associated with deployment to Iraq or Afghanistan compared with nondeployed personnel; and with Army and Marine Corps personnel compared with Navy and Air Force personnel. “Our study provided valuable insight for the mental health readiness of the U.S. armed services and implications for potential, continued support of ongoing operations and their post deployment health care needs,” stated the study’s authors.

“Given the continuing U.S. military presence in Afghanistan and other parts of the world, and the increasing trend in major mental health conditions reported in the U.S. military, it would be important for the Department of Defense to access whether the current system has adequate resources and manpower to handle the increasing number of active duty personnel who need mental health services,” the study’s authors concluded.

[From: “Effects of Iraq/Afghanistan Deployments on Major Depression and Substance Use Disorder: Analysis of Active Duty Personnel in the US Military.” ]. ###

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