Mental health consequences of overstretch in the UK armed forces: first phase of a cohort study

doi:10.1136/bmj.39274.585752.BE

BMJ, doi: 10.1136/bmj.39274.585752.BE, (Published 30 July 2007)

Research

Mental health consequences of overstretch in the UK armed forces: first phase of a cohort study

Roberto J Rona, professor of public health¹, Nicola T Fear, senior lecturer in military epidemiology², Lisa Hull, study coordinator¹, Neil Greenberg, senior lecturer in military psychiatry², Mark Earnshaw, research fellow², Matthew Hotopf, professor of general hospital psychiatry¹, Simon Wessely, professor of epidemiology and liaison psychiatry¹

¹ King's College London, King's Centre for Military Health Research, Weston Education Centre, London SE5 9RJ, ² Academic Centre for Defence Mental Health, Weston Education Centre

Correspondence to: R J Rona roberto.rona{at}iop.kcl.ac.uk

Objective To assess the relation between frequency and durationof deployment of UK armed forces personnel on mental health.

Design First phase of a cohort study.

Setting UK armed forces personnel.

Participants Operational history in past three years of a randomlychosen stratified sample of 5547 regulars with experience ofdeployment.

Main outcome measures Psychological distress (general healthquestionnaire-12), caseness for post-traumatic stress disorder,physical symptoms, and alcohol use (alcohol use disorders identificationtest).

Results Personnel who were deployed for 13 months or more inthe past three years were more likely to fulfil the criteriafor post-traumatic stress disorder (odds ratio 1.55, 95% confidenceinterval 1.07 to 2.32), show caseness on the general healthquestionnaire (1.35, 1.10 to 1.63), and have multiple physicalsymptoms (1.49, 1.19 to 1.87). A significant association wasfound between duration of deployment and severe alcohol problems.Exposure to combat partly accounted for these associations.The associations between number of deployments in the past threeyears and mental disorders were less consistent than those relatedto duration of deployment. Post-traumatic stress disorder wasalso associated with a mismatch between expectations about theduration of deployment and the reality.

Conclusions A clear and explicit policy on the duration of eachdeployment of armed forces personnel may reduce the risk ofpost-traumatic stress disorder. An association was found betweendeployment for more than a year in the past three years andmental health that might be explained by exposure to combat.

Add to CiteULike CiteULike Add to Complore Complore Add to Connotea Connotea Add to Del.icio.us Del.icio.us Add to Digg Digg Add to Reddit Reddit Add to Technorati Technorati What's this?

Relevant Articles

Mental illness in deployed soldiers: R J Ursano, D M Benedek, and C C Engel
BMJ 2007 335: 571-572. [Extract] [Full Text] [PDF]

Charities say UK government must do more to help soldiers returning from battle: Owen Dyer
BMJ 2007 335: 364-365. [Extract] [Full Text] [PDF]

Mental health screening in armed forces before the Iraq war and prevention of subsequent psychological morbidity: follow-up study: Roberto J Rona, Richard Hooper, Margaret Jones, Lisa Hull, Tess Browne, Oded Horn, Dominic Murphy, Matthew Hotopf, and Simon Wessely
BMJ 2006 333: 991. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

Jacobson, I. G., Ryan, M. A. K., Hooper, T. I., Smith, T. C., Amoroso, P. J., Boyko, E. J., Gackstetter, G. D., Wells, T. S., Bell, N. S. (2008). Alcohol Use and Alcohol-Related Problems Before and After Military Combat Deployment. JAMA 300: 663-675 [Abstract] [Full text]
Jones, M., Fear, N. T., Greenberg, N., Jones, N., Hull, L., Hotopf, M., Wessely, S., Rona, R. J. (2008). Do medical services personnel who deployed to the Iraq war have worse mental health than other deployed personnel?. Eur J Public Health 18: 422-427 [Abstract] [Full text]
(2007). Prolonged Military Deployment in Iraq Increases Mental Health Problems. JWatch General 2007: 5-5 [Full text]
Ursano, R J, Benedek, D M, Engel, C C (2007). Mental illness in deployed soldiers. BMJ 335: 571-572 [Full text]

Rapid Responses:

Read all Rapid Responses

CRITICAL APPRAISAL: ABRAHAM P. GEORGE, et al.
bmj.com, 4 Aug 2007 [Full text]
Is there a different peak for PTSD in armed forces reserves?: Jude N Chukwuma
bmj.com, 4 Aug 2007 [Full text]
Who needs Wars?: David Richard Musa
bmj.com, 24 Sep 2007 [Full text]
What about those who do not want to take part in research?: Jelena Jankovic
bmj.com, 26 Sep 2007 [Full text]
One year in a war zone is enough: Anthony P Hall
bmj.com, 28 Sep 2007 [Full text]
Mental health consequences of overstretch � what about hospital emergency departments?: Martin Wiese
bmj.com, 7 Oct 2007 [Full text]