Recent studies have indicated that service-members deployed in Operation Iraqi Freedom (OIF) or Operation Enduring Freedom (OEF) have experienced co-occurring physical and mental health problems.  Carlson and her colleagues found that veterans with positive traumatic brain injury screens were three times more likely to have a diagnosis for post-traumatic stress disorder (PTSD), anxiety, and adjustment disorder and were two times more likely to have depression and substance-related diagnoses.  Combat soldiers with severe physical injuries frequently developed PTSD or depression later (Grieger et al., 2006).  Veterans who screened positive for PTSD were more than four times as likely to endorse suicidal ideation relative to non-PTSD veterans (Jakcupcak et al., 2009).

Kim and his colleagues (2010) have found that 44% of active duty and 35% of National Guard reported reintegration stresses a year after OIF/OEF deployment.  Stresses included relationship problems with spouse and children, significant depression, anger and aggression, and substance abuse (Castro & Hoge, 2010; Sayer et al., 2010).

As the number of women who enter military service has increased (about 12% of those who have served in OEF/OIF), the number of reported instances of sexual harassment and military sexual trauma (MST) has increased.  Of the 17,580 women and 108,149 men who were screened for MST from October 1, 2001 to September 30, 2007, 15.1% of the women and .7% of the men reported MST.  MST was associated with a higher incidence of PTSD, anxiety, depression, and substance use disorders (Kimerling et al., 2010).

With more than 101,000 active duty, 12,000 National Guard, and over 10,200 Reservists in the state of North Carolina, the treatment of post-deployment mental health problems must be considered as many combat veterans and their families associate stigma with seeing a mental health provider (Kim et al., 2010; Kudler & Straits-Tröster, 2008).

SELECTED REFERENCES

Carlson KF, Nelson D, Orazem RJ, Nugent S, Cifu DX, Sayer NA.  Psychiatric diagnoses among Iraq and Afghanistan war veterans screened for deployment-related traumatic brain injury.  Journal of Traumatic Stress.  2010;23(1):17-24.

Castro CA, Hoge CW.  Prevalence of mental health problems and functional impairment among active component and National Guard soldiers 3 and 12 months following combat in Iraq.  Archives of General Psychiatry. 2010;67(6):614-23.

Grieger TA, Cozza SJ, Ursano RJ, Hoge C, Martinez PE, Engel CC, Wain HJ.  Posttraumatic stress disorder and depression in battle-injured soldiers.  American Journal of Psychiatry.  2006;163(10):1777-83.

Jakupcak M, Cook J, Imel Z, Fontana A, Rosenheck R, McFall M.  Posttraumatic stress disorder as a risk factor for suicidal ideation in Iraq and Afghanistan War veterans.  Journal of Traumatic Stress. 2009;22(4):303-6.

Kim PY, Thomas JL, Wilk JE, Castro CA, Hoge CW.  Stigma, barriers to care, and use of mental health services among active duty and National Guard soldiers after combat.  Psychiatric Services. 2010;61(6):582-8.

Kimerling R, Street AE, Pavao J, Smith MW, Cronkite RC, Holmes TH, Frayne SM.  Military-related sexual trauma among Veterans Health Administration patients returning from Afghanistan and Iraq. American Journal of Public Health. 2010;100(8):1409-12.

Kudler H, Straits-Tröster K.  Identifying and treating post deployment mental health problems among new combat veterans.  NC Medical Journal.  2008:69(1);39-41.

Sayer NA, Noorbaloochi S, Frazier P, Carlson K, Gravely A, Murdoch M.  Reintegration problems and treatment interests among Iraq and Afghanistan combat veterans receiving VA medical care.  Psychiatric Services.  2010;61(6):589-97.