• Online Features  This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (168)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Psychiatry  • Post Traumatic Stress Disorder  • Stress  • Psychiatry, Other  • Violence and Human Rights  • Bioterrorism  • War  • Alert me on articles by topic  Social Bookmarking   What's this?

Mental Health Disorders Among 103 788 US Veterans Returning From Iraq and Afghanistan Seen at Department of Veterans Affairs Facilities

Karen H. Seal, MD, MPH; Daniel Bertenthal, MPH; Christian R. Miner, PhD; Saunak Sen, PhD; Charles Marmar, MD

Arch Intern Med. 2007;167(5):476-482.

Background  Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) have endured high combat stress and are eligible for 2 years of free military service–related health care through the Department of Veterans Affairs (VA) health care system, yet little is known about the burden and clinical circumstances of mental health diagnoses among OEF/OIF veterans seen at VA facilities.

Methods  US veterans separated from OEF/OIF military service and first seen at VA health care facilities between September 30, 2001 (US invasion of Afghanistan), and September 30, 2005, were included. Mental health diagnoses and psychosocial problems were assessed using International Classification of Diseases, Ninth Revision, Clinical Modification codes. The prevalence and clinical circumstances of and subgroups at greatest risk for mental health disorders are described herein.

Results  Of 103 788 OEF/OIF veterans seen at VA health care facilities, 25 658 (25%) received mental health diagnosis(es); 56% of whom had 2 or more distinct mental health diagnoses. Overall, 32 010 (31%) received mental health and/or psychosocial diagnoses. Mental health diagnoses were detected soon after the first VA clinic visit (median of 13 days), and most initial mental health diagnoses (60%) were made in nonmental health clinics, mostly primary care settings. The youngest group of OEF/OIF veterans (age, 18-24 years) were at greatest risk for receiving mental health or posttraumatic stress disorder diagnoses compared with veterans 40 years or older.

Conclusions  Co-occurring mental health diagnoses and psychosocial problems were detected early and in primary care medical settings in a substantial proportion of OEF/OIF veterans seen at VA facilities. Targeted early detection and intervention beginning in primary care settings are needed to prevent chronic mental illness and disability.

Author Affiliations: Departments of Medicine (Dr Seal), Epidemiology and Biostatistics (Dr Sen), and Psychiatry (Dr Marmar), University of California, San Francisco, and Health Services Research and Development Research Enhancement Award Program (Mr Bertenthal), San Francisco VA Medical Center, San Francisco (Drs Seal, Miner, Sen, and Marmar).

CiteULike    Connotea    Delicious    Digg    Facebook    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Deployment and Mental Health Diagnoses Among Children of US Army Personnel
Mansfield et al.
Arch Pediatr Adolesc Med 2011;165:999-1005.
ABSTRACT | FULL TEXT  

A brief self-guided telehealth intervention for post-traumatic stress disorder in combat veterans: a pilot study
Possemato et al.
J Telemed Telecare 2011;17:245-250.
ABSTRACT | FULL TEXT  

Mental health and unintentional injurers: results from the national co-morbidity survey replication
Connorton et al.
Inj. Prev. 2011;17:171-175.
ABSTRACT | FULL TEXT  

Veteran Family Reintegration, Primary Care Needs, and the Benefit of the Patient-Centered Medical Home Model
Hinojosa et al.
J Am Board Fam Med 2010;23:770-774.
ABSTRACT | FULL TEXT  

Psychological Problems Associated With Operation Enduring Freedom/Operation Iraqi Freedom Deployment
Scioli et al.
AMERICAN JOURNAL OF LIFESTYLE MEDICINE 2010;4:349-359.
ABSTRACT  

Veterans and the Justice System: The Next Forensic Frontier
Pinals
J Am Acad Psychiatry Law 2010;38:163-167.
FULL TEXT  

Association Between Posttraumatic Stress Disorder and Primary Care Provider-Diagnosed Disease Among Iraq and Afghanistan Veterans
Andersen et al.
Psychosom. Med. 2010;72:498-504.
ABSTRACT | FULL TEXT  

A qualitative analysis of the tobacco control climate in the U.S. military
Jahnke et al.
Nicotine Tob Res 2010;12:88-95.
ABSTRACT | FULL TEXT  

Prevalence Estimates of Combat-Related Post-Traumatic Stress Disorder: Critical Review
Richardson et al.
Aust N Z J Psychiatry 2010;44:4-19.
ABSTRACT | FULL TEXT  

Suicide Mortality Among Patients Receiving Care in the Veterans Health Administration Health System
McCarthy et al.
Am J Epidemiol 2009;169:1033-1038.
ABSTRACT | FULL TEXT  

The Aftermath of Combat-Related PTSD: Toward an Understanding of Transgenerational Trauma
Pearrow and Cosgrove
Communication Disorders Quarterly 2009;30:77-82.
ABSTRACT  

Globalization, Conflict and Mental Health
Piachaud
Global Social Policy 2008;8:315-334.
ABSTRACT  

Validation of Scales From the Deployment Risk and Resilience Inventory in a Sample of Operation Iraqi Freedom Veterans
Vogt et al.
Assessment 2008;15:391-403.
ABSTRACT  

Re: "Psychiatric Diagnoses in Historic and Contemporary Military Cohorts: Combat Deployment and the Healthy Warrior Effect
Hoge
Am J Epidemiol 2008;168:1095-1096.
FULL TEXT  

Understanding Sequelae of Injury Mechanisms and Mild Traumatic Brain Injury Incurred during the Conflicts in Iraq and Afghanistan: Persistent Postconcussive Symptoms and Posttraumatic Stress Disorder
Schneiderman et al.
Am J Epidemiol 2008;167:1446-1452.
ABSTRACT | FULL TEXT  

Longitudinal Assessment of Mental Health Problems Among Active and Reserve Component Soldiers Returning From the Iraq War
Milliken et al.
JAMA 2007;298:2141-2148.
ABSTRACT | FULL TEXT