More than one-third of U.S. veterans seen at Veterans Affairs (VA) hospitals after serving in Iraq or Afghanistan were diagnosed with a mental health disorder, such as post-traumatic stress disorder (PTSD) or depression, according to a new study.
Using national VA data on more than 289,000 Iraq and Afghanistan vets, researchers found that the prevalence of new mental health diagnoses increased by six-fold between 2002 and 2008 – from just over 6 percent to 37 percent.
The steepest increase was seen in new diagnoses of PTSD, which rose from less than 1 percent of VA patients at the outset to 22 percent by the study’s end.
That was followed by depression, which was diagnosed in 17 percent of veterans, versus roughly 2 percent in 2002.
By comparison, experts estimate that in the general U.S. population, about 8 percent of people will suffer from PTSD at some point in their lives, and roughly 7 percent of adults will develop major depression in a given year.
“What’s really striking is the dramatic acceleration in mental health diagnoses, particularly PTSD, after the beginning of the conflict in Iraq on March 20, 2003,” lead researcher Dr. Karen Seal, a staff physician at the San Francisco VA Medical Center, noted in a written statement.
The findings support efforts to screen for and treat veterans’ mental health problems early, Seal and her colleagues report in the American Journal of Public Health.
After June 2004, the researchers note, the VA started a system-wide screening program for PTSD, depression and alcohol abuse – which may be one reason for the increases in diagnoses since 2002.
The VA also recently changed policy to extend free service-related healthcare to five years, which, Seal’s team writes, will likely help find more veterans in need of treatment.
In addition to the changes in PTSD and depression, diagnoses of alcohol and drug abuse increased during the study period. The prevalence of alcohol-use disorders rose from 1 percent to 7 percent, while drug-use disorders increased from 0.2 percent to 3 percent.
When it came to risk factors for mental health problems, the study found that active-duty personnel differed from those in the National Guard or reserves.
Among active-duty military, veterans younger than 25 had about twice the risks of PTSD or alcohol or drug abuse than vets older than 40.
Among reserve troops, vets older than 40 had a higher risk of both PTSD and depression than their youngest counterparts.
Younger active-duty veterans likely saw more combat than their older counterparts, Seal’s team points out, and that may help explain their higher PTSD risk. The reasons for the higher risk among older reservists are not clear and warrant further study, the researchers write.
As for the overall increase in mental health diagnoses after the start of the Iraq War, there may be several reasons, according to the researchers.
Multiple and more-lengthy deployments, as well as “waning public support” for the Iraq War and lower morale among troops, may have played some role, the researchers write.
SOURCE: American Journal of Public Health, online July 16, 2009.