Trends and Risk Factors for Mental Health Diagnoses Among Iraq and Afghanistan Veterans Using Department of Veterans Affairs Health Care, 2002-2008
Trends and Risk Factors for Mental Health Diagnoses Among Iraq and Afghanistan Veterans Using Department of Veterans Affairs Health Care, 2002-2008
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DOI：
10.2105/ajph.2008.150284
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发表时间：
2009-09-01
影响因子：
12.7
通讯作者：
Marmar, Charles R.
中科院分区：
文献类型：
--
作者：
Seal, Karen H.;Metzler, Thomas J.;Marmar, Charles R.
目标。我们试图调查伊拉克和阿富汗退伍军人心理健康诊断的纵向趋势和危险因素。我们利用国家退伍军人事务部（VA）的数据，确定了2002年至2008年期间进入退伍军人事务部（VA）卫生保健中心的289328名伊拉克和阿富汗退伍军人的心理健康诊断的患病率和预测因素。在289328名伊拉克和阿富汗退伍军人中，106726名（36.9%）接受了心理健康诊断；62929人（21.8%）诊断为创伤后应激障碍（PTSD）， 50432人（17.4%）诊断为抑郁症。伊拉克战争后，PTSD的2年患病率增加了4 - 7倍。25岁以下的现役退伍军人与40岁以上的现役退伍军人相比，PTSD、酒精和药物使用障碍的诊断率更高（调整后的相对危险度分别为2.0和4.9）。女性患抑郁症的风险比男性高，但男性患药物滥用障碍的风险是男性的两倍多。更多的战斗暴露与更高的创伤后应激障碍风险相关。伊拉克战争开始后，在进入退伍军人医疗保健中心的退伍军人的特定亚群中，心理健康诊断大幅增加。早期有针对性的干预可以预防慢性精神疾病。[J] .中华卫生杂志，2009;39(1):551 - 558。doi: 10.2105 / AJPH.2008.150284)
Objectives. We sought to investigate longitudinal trends and risk factors for mental health diagnoses among Iraq and Afghanistan veterans.Methods. We determined the prevalence and predictors of mental health diagnoses among 289328 Iraq and Afghanistan veterans entering Veterans Affairs (VA) health care from 2002 to 2008 using national VA data.Results. Of 289328 Iraq and Afghanistan veterans, 106726 (36.9%) received mental health diagnoses; 62929 (21.8%) were diagnosed with posttraumatic stress disorder (PTSD) and 50432 (17.4%) with depression. Adjusted 2-year prevalence rates of PTSD increased 4 to 7 times after the invasion of Iraq. Active duty veterans younger than 25 years had higher rates of PTSD and alcohol and drug use disorder diagnoses compared with active duty veterans older than 40 years (adjusted relative risk=2.0 and 4.9, respectively). Women were at higher risk for depression than were men, but men had over twice the risk for drug use disorders. Greater combat exposure was associated with higher risk for PTSD.Conclusions. Mental health diagnoses increased substantially after the start of the Iraq War among specific subgroups of returned veterans entering VA health care. Early targeted interventions may prevent chronic mental illness. (Am J Public Health. 2009;99:1651-1658. doi:10.2105/AJPH.2008.150284)