Skip to main content Accessibility help
×
Home

Prevalence of Mental Health Symptoms in Dutch Military Personnel Returning from Deployment to Afghanistan: A 2-year Longitudinal Analysis

  • A. Reijnen (a1) (a2) (a3), A.R. Rademaker (a1), E. Vermetten (a1) (a2) (a3) (a4) and E. Geuze (a1) (a2)

Abstract

Objective:

Recent studies in troops deployed to Iraq and Afghanistan have shown that combat exposure and exposure to deployment-related stressors increase the risk for the development of mental health symptoms. The aim of this study is to assess the prevalence of mental health symptoms in a cohort of Dutch military personnel prior to and at multiple time-points after deployment.

Methods:

Military personnel (n = 994) completed various questionnaires at 5 time-points; starting prior to deployment and following the same cohort at 1 and 6 months and 1 and 2 years after their return from Afghanistan.

Results:

The prevalence of symptoms of fatigue, PTSD, hostility, depression and anxiety was found to significantly increase after deployment compared with pre-deployment rates. As opposed to depressive symptoms and fatigue, the prevalence of PTSD was found to decrease after the 6-month assessment. The prevalence of sleeping problems and hostility remained relatively stable.

Conclusions:

The prevalence of mental health symptoms in military personnel increases after deployment, however, symptoms progression over time appears to be specific for various mental health symptoms. Comprehensive screening and monitoring for a wide range of mental health symptoms at multiple time-points after deployment is essential for early detection and to provide opportunities for intervention.

Declaration of interest:

This project was funded by the Dutch Ministry of Defence.

Copyright

Corresponding author

Corresponding author at: Military Mental Health Research Center, P.O. Box 90.000, 3509 AA Utrecht, The Netherlands. Tel.: +31 30 2502587. E-mail address:A.Reijnen@umcutrecht.nl (A. Reijnen).

References

Hide All
[1]Alonso, J., Angermeyer, M.C., Bernert, S., Bruffaerts, R., Brugha, T.S., Bryson, H., et al.12-month comorbidity patterns and associated factors in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatr Scand 2004;109 :2837.
[2]APA. Diagnostic and statistical manual of mental disorders, 4th-Text Revision ed.Washington: APA; 2000.
[3]Arrindell, W.A., Ettema, J.H.M.SCL-90: Revised manual for a multidimensional indicator of psychopathology In: Herziene handleiding bij een multidimensionele psychopathologie indicator. Lisse, the Netherlands: Swets & Zeitlinger; 2003.
[4]Berntsen, D., Johannessen, K.B., Thomsen, Y.D., Bertelsen, M., Hoyle, R.H., Rubin, D.C.Peace and war: trajectories of posttraumatic stress disorder symptoms before, during, and after military deployment in Afghanistan. Psychol Sci 2012;23 :15571565.
[5]Bliese, P.D., Wright, K.M., Adler, A.B., Thomas, J.L., Hoge, C.W.Timing of postcombat mental health assessments. Psychol Serv 2007;4 :141148.
[6]Bonanno, G.A.Loss, trauma, and human resilience: have we underestimated the human capacity to thrive after extremely aversive events?. Am Psychol 2004;59 :2028.
[7]Bonanno, G.A., Mancini, A.D., Horton, J.L., Powell, T.M., Leardmann, C.A., Boyko, E.J., et al.Trajectories of trauma symptoms and resilience in deployed US military service members: prospective cohort study. Br J Psychiatry 2012;200 :317323.
[8]de Vries, M., Soetekouw, P.M., Van Der Meer, J.W., Bleijenberg, G.Fatigue in Cambodia veterans. QJM 2000;93 :283289.
[9]Dickstein, B.D., Suvak, M., Litz, B.T., Adler, A.B.Heterogeneity in the course of posttraumatic stress disorder: trajectories of symptomatology. J Trauma Stress 2010;23 :331339.
[10]Dohrenwend, B.P.The role of adversity and stress in psychopathology: some evidence and its implications for theory and research. J Health Soc Behav 2000;41 :119.
[11]Elbogen, E.B., Johnson, S.C., Wagner, H.R., Newton, V.M., Timko, C., Vasterling, J.J., et al.Protective factors and risk modification of violence in Iraq and Afghanistan war veterans. J Clin Psychiatry 2012;73 :e767e773.
[12]Engelhard, I.M., Van den Hout, M.A., Weerts, J., Arntz, A., Hox, J.J., McNally, R.J.Deployment-related stress and trauma in Dutch soldiers returning from Iraq. Prospective study. Br J Psychiatry 2007;191 :140145.
[13]Fear, N.T., Jones, M., Murphy, D., Hull, L., Iversen, A.C., Coker, B., et al.What are the consequences of deployment to Iraq and Afghanistan on the mental health of the UK armed forces? A cohort study. Lancet 2010;375 :17831797.
[14]Frueh, B.C., Hamner, M.B., Cahill, S.P., Gold, P.B., Hamlin, K.L.Apparent symptom overreporting in combat veterans evaluated for PTSD. Clin Psychol Rev 2000;20 :853885.
[15]Hafkenscheid, A., Maassen, G., Veeninga, A.The dimensions of the Dutch SCL-90: more than one, but how many?. NEJP 2007;63 :2530.
[16]Harrison, J.P., Satterwhite, L.F., Ruday, W. Jr.The financial impact of posttraumatic stress disorder on returning US military personnel. J Health Care Finance 2010;36 :6574.
[17]Hoge, C.W., Auchterlonie, J.L., Milliken, C.S.Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan. J Am Med Assoc 2006;295 :10231032.
[18]Hoge, C.W., Castro, C.A., Messer, S.C., McGurk, D., Cotting, D.I., Koffman, R.L.Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. N Engl J Med 2004;351 :1322.
[19]Hotopf, M., Hull, L., Fear, N.T., Browne, T., Horn, O., Iversen, A., et al.The health of UK military personnel who deployed to the 2003 Iraq war: a cohort study. Lancet 2006;367 :17311741.
[20]Hovens, J.E., Bramsen, I., van der Ploeg, H.M.Self-report measure for PTSD symptoms: SIP manual In: De Zelfinventarisatielijst Post traumatische Stressstoornis: ZIL handleiding, Lisse/Leiden, the Netherlands: Swets & Zeitlinger; 2000.
[21]Hovens, J.E., Bramsen, I., Van Der Ploeg, H.M.Self-rating inventory for posttraumatic stress disorder: review of the psychometric properties of a new brief Dutch screening instrument. Percept Mot Skills 2002;94 :9961008.
[22]Hovens, J.E., van der Ploeg, H.M., Bramsen, I., Klaarenbeek, M.T., Schreuder, J.N., Rivero, V.V.The development of the self-rating inventory for posttraumatic stress disorder. Acta Psychiatr Scand 1994;90 :172183.
[23]Iversen, A.C., van Staden, L., Hughes, J.H., Browne, T., Hull, L., Hall, J., et al.The prevalence of common mental disorders and PTSD in the UK military: using data from a clinical interview-based study. BMC Psychiatry 2009 9.
[24]Johnson, J.G., Cohen, P., Dohrenwend, B.P., Link, B.G., Brook, J.S.A longitudinal investigation of social causation and social selection processes involved in the association between socioeconomic status and psychiatric disorders. J Abnorm Psychol 1999;108 :490499.
[25]Jones, M., Sundin, J., Goodwin, L., Hull, L., Fear, N.T., Wessely, S., et al.What explains posttraumatic stress disorder (PTSD) in UK service personnel: deployment or something else?. Psychol Med 2013;43 :17031712.
[26]Kang, H.K., Natelson, B.H., Mahan, C.M., Lee, K.Y., Murphy, F.M.Posttraumatic stress disorder and chronic fatigue syndrome-like illness among Gulf War veterans: a population-based survey of 30,000 veterans. Am J Epidemiol 2003;157 :141148.
[27]Milliken, C.S., Auchterlonie, J.L., Hoge, C.W.Longitudinal assessment of mental health problems among active and reserve component soldiers returning fromthe Iraq war. J Am Med Assoc 2007;298 :21412148.
[28]Orcutt, H.K., Erickson, D.J., Wolfe, J.The course of PTSD symptoms among Gulf War veterans: a growth mixture modeling approach. J Trauma Stress 2004;17 :195202.
[29]Polusny, M.A., Erbes, C.R., Murdoch, M., Arbisi, P.A., Thuras, P., Rath, M.B.Prospective risk factors for new onset posttraumatic stress disorder in national guard soldiers deployed to Iraq. Psychol Med 2011;41 :687698.
[30]Ren, X.S., Skinner, K., Lee, A., Kazis, L.Social support, social selection and self-assessed health status: results from the veterans health study in the United States. Soc Sci Med 1999;48 :17211734.
[31]Richardson, L.K., Frueh, B.C., Acierno, R.Prevalence estimates of combat-related posttraumatic stress disorder: critical review. Aust N Z J Psychiatry 2010;44 :419.
[32]Rona, R.J., Hooper, R., Jones, M., Hull, L., Browne, T., Horn, O., et al.Mental health screening in armed forces before the Iraq war and prevention of subsequent psychological morbidity: follow-up study. Br Med J 2006;333 :991994.
[33]Rona, R.J., Hooper, R., Jones, M., Iversen, A.C., Hull, L., Murphy, D., et al.The contribution of prior psychological symptoms and combat exposure to post Iraq deployment mental health in the UK military. J Trauma Stress 2009;22 :1119.
[34]Schmitz, N., Hartkamp, N., Kiuse, J., Franke, G.H., Reister, G., Tress, W.The Symptom Checklist-90-R (SCL-90-R): a German validation study. Qual Life Res 2000;9 :185193.
[35]Shen, Y.C., Arkes, J., Williams, T.V.Effects of Iraq/Afghanistan deployments on major depression and substance use disorder: analysis of active duty personnel in the US military. Am J Public Health 2012;102 (Suppl. 1):S80S87.
[36]Smid, G.E., Kleber, R.J., Rademaker, A.R., van Zuiden, M., Vermetten, E.The role of stress sensitization in progression of posttraumatic distress following deployment. Soc Psychiatry Psychiatr Epidemiol 2013;48 :17431754.
[37]Smith, T.C., Ryan, M.A., Wingard, D.L., Slymen, D.J., Sallis, J.F., Kritz-Silverstein, D.New onset and persistent symptoms of posttraumatic stress disorder self-reported after deployment and combat exposures: prospective population-based US military cohort study. BMJ 2008;336 :366371.
[38]Solomon, Z., Mikulincer, M.Life events and combat-related posttraumatic stress disorder: the intervening role of locus of control and social support. Mil Psychol 1990;2 :241256.
[39]Sveen, J., Ekselius, L., Gerdin, B., Willebrand, M.A prospective longitudinal study of posttraumatic stress disorder symptom trajectories after burn injury. J Trauma 2011;71 :18081815.
[40]Thomas, J.L., Wilk, J.E., Riviere, L.A., McGurk, D., Castro, C.A., Hoge, C.W.Prevalence of mental health problems and functional impairment among active component and national guard soldiers 3 and 12 months following combat in Iraq. Arch Gen Psychiatry 2010;67 :614623.
[41]van Zelst, W.H., de Beurs, E., Beekman, A.T., Deeg, D.J., Bramsen, I., van Dyck, R.Criterion validity of the self-rating inventory for posttraumatic stress disorder (SRIP) in the community of older adults. J Affect Disord 2003;76 :229235.
[42]Vasterling, J.J., Proctor, S.P., Friedman, M.J., Hoge, C.W., Heeren, T., King, L.A., et al.PTSD symptom increases in Iraq-deployed soldiers: comparison with non-deployed soldiers and associations with baseline symptoms, deployment experiences, and post-deployment stress. J Trauma Stress 2010;23 :4151.
[43]Vercoulen, J.H.M.M., Alberts, M., Bleijenberg, G.De checklist individuele spankracht (CIS). Gedragstherapie 1999;32 :131136.

Keywords

Prevalence of Mental Health Symptoms in Dutch Military Personnel Returning from Deployment to Afghanistan: A 2-year Longitudinal Analysis

  • A. Reijnen (a1) (a2) (a3), A.R. Rademaker (a1), E. Vermetten (a1) (a2) (a3) (a4) and E. Geuze (a1) (a2)

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.

Prevalence of Mental Health Symptoms in Dutch Military Personnel Returning from Deployment to Afghanistan: A 2-year Longitudinal Analysis

  • A. Reijnen (a1) (a2) (a3), A.R. Rademaker (a1), E. Vermetten (a1) (a2) (a3) (a4) and E. Geuze (a1) (a2)
Submit a response

Comments

No Comments have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *