Longitudinal Mental Health Outcomes of Combat-injured Service Members

Overview

Journal Brain Behav

Specialty Psychology

Date 2021 Mar 4

PMID 33662185

Citations 10

Authors

Lauren E Walker

Jessica Watrous

Eduard Poltavskiy

Jeffrey T Howard

Jud C Janak

Warren B P Pettey

Lee Ann Zarzabal

Alan Sim

Adi Gundlapalli

Ian J Stewart

Affiliations

Soon will be listed here.

Abstract

Background: The relationship between traumatic injury and subsequent mental health diagnoses is not well understood and may have significant implications for patient screening and clinical intervention. We sought to determine the adjusted association between traumatic injury and the subsequent development of post-traumatic stress disorder (PTSD), depression, and anxiety.

Methods: Using Department of Defense and Veterans Affairs datasets between February 2002 and June 2016, we conducted a retrospective cohort study of 7,787 combat-injured United States service members matched 1:1 to combat-deployed, uninjured service members. The primary exposure was combat injury versus no combat injury. Outcomes were diagnoses of PTSD, depression, and anxiety, defined by International Classification of Diseases 9th and 10th Revision Clinical Modification codes.

Results: Compared to noninjured service members, injured service members had higher observed incidence rates per 100 person-years for PTSD (17.1 vs. 5.8), depression (10.4 vs. 5.7), and anxiety (9.1 vs. 4.9). After adjustment, combat-injured patients were at increased risk of development of PTSD (HR 2.92, 95%CI 2.68-3.17), depression (HR 1.47, 95%CI 1.36-1.58), and anxiety (HR 1.34, 95%CI 1.24-1.45).

Conclusions: Traumatic injury is associated with subsequent development of PTSD, depression, and anxiety. These findings highlight the importance of increased screening, prevention, and intervention in patients with exposure to physical trauma.

Citing Articles

Traumatic Brain Injury and Risk of Incident Comorbidities.

Halabi C, Izzy S, DiGiorgio A, Mills H, Radmanesh F, Yue J JAMA Netw Open. 2024; 7(12):e2450499.

PMID: 39666337 PMC: 11638795. DOI: 10.1001/jamanetworkopen.2024.50499.

Comparison of Racial and Ethnic Mortality Disparities among Post-9/11 Veterans with and without Traumatic Brain Injury to the Total U.S. Adult Population.

Howard J, Stewart I, Walker L, Amuan M, Rayha K, Janak J J Racial Ethn Health Disparities. 2024; .

PMID: 38622427 DOI: 10.1007/s40615-024-02004-1.

Mental and Physical Health-Related Quality of Life Following Military Polytrauma.

McDonald J, Wagoner M, Shaikh F, Sercy E, Stewart L, Knapp E Mil Med. 2024; 189(11-12):2550-2561.

PMID: 38421743 PMC: 11536322. DOI: 10.1093/milmed/usae055.

Traumatic Brain Injury and Subsequent Risk of Brain Cancer in US Veterans of the Iraq and Afghanistan Wars.

Stewart I, Howard J, Poltavskiy E, Dore M, Amuan M, Ocier K JAMA Netw Open. 2024; 7(2):e2354588.

PMID: 38358743 PMC: 10870183. DOI: 10.1001/jamanetworkopen.2023.54588.

Bidirectional Associations Between Pain and Perceived Stress Among Veterans: Depressive Disorder as a Predisposing Factor.

Saba S, Davis J, Prindle J, Howe E, Tran D, Bunyi J Psychosom Med. 2023; 86(1):44-51.

PMID: 37774110 PMC: 10841244. DOI: 10.1097/PSY.0000000000001253.

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