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Open Access Research article

What are the effects of having an illness or injury whilst deployed on post deployment mental health? A population based record linkage study of UK Army personnel who have served in Iraq or Afghanistan

Harriet J Forbes1, Norman Jones3, Charlotte Woodhead2, Neil Greenberg3, Kate Harrison4, Sandra White4, Simon Wessely2 and Nicola T Fear3*

Author Affiliations

1 London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK

2 King’s Centre for Military Health Research, King’s College London, Weston Education Centre, 10 Cutcombe Road, London, SE5 9RJ, UK

3 Academic Centre for Defence Mental Health, King’s College London, Weston Education Centre, 10 Cutcombe Road, London, SE5 9RJ, UK

4 DASA Health Information, Defence Analytical Services and Advice (DASA), UK Ministry of Defence, Ensleigh, Bath, BA1 5AB, UK

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BMC Psychiatry 2012, 12:178  doi:10.1186/1471-244X-12-178

Published: 24 October 2012

Abstract

Background

The negative impact of sustaining an injury on a military deployment on subsequent mental health is well-documented, however, the relationship between having an illness on a military operation and subsequent mental health is unknown.

Methods

Population based study, linking routinely collected data of attendances at emergency departments in military hospitals in Iraq and Afghanistan [Operational Emergency Department Attendance Register (OpEDAR)], with data on 3896 UK Army personnel who participated in a military health study between 2007 and 2009 and deployed to Iraq or Afghanistan between 2003 to 2009.

Results

In total, 13.8% (531/3896) of participants had an event recorded on OpEDAR during deployment; 2.3% (89/3884) were medically evacuated. As expected, those medically evacuated for an injury were at increased risk of post deployment probable PTSD (odds ratio 4.27, 95% confidence interval 1.80-10.12). Less expected was that being medically evacuated for an illness was also associated with a similarly increased risk of probable PTSD (4.39, 1.60-12.07) and common mental disorders (2.79, 1.41-5.51). There was no association between having an OpEDAR event and alcohol misuse. Having an injury caused by hostile action was associated with increased risk of probable PTSD compared to those with a non-hostile injury (3.88, 1.15 to 13.06).

Conclusions

Personnel sustaining illnesses on deployment are just as, if not more, at risk of having subsequent mental health problems as personnel who have sustained an injury. Monitoring of mental health problems should consider those with illnesses as well as physical injuries.

Keywords:
Mental Health; Military; PTSD; Alcohol use; Depression; Deployment