Military personnel with diminished mental or physical health before combat exposure are more vulnerable to developing post-traumatic stress disorder (PTSD) after deployment, finds a study published on bmj.com today.
The researchers suggest that those at risk could be offered post-traumatic stress prevention programs or even protection from stressful exposures.
Concerns have been raised about the health impact of military deployment, but it is unclear if those with decreased mental or physical health are more vulnerable to developing PTSD.
To investigate this further, a team of US researchers studied 5,410 military servicemen and women who were taking part in the Millennium Cohort Study (a large 21-year study of the health of US military personnel). All participants were free of PTSD symptoms and diagnosis at the start of the study.
Two questionnaires were used to collect data on the mental and physical health of each individual before and after combat exposure. Higher scores on the questionnaires reflected more favourable health status.
The first (baseline) questionnaire was completed between 2001 and 2003, before any of the participants had been exposed to combat. The second (follow-up) questionnaire was completed between 2004 and 2006, after participants had their first combat deployment in support of wars in Iraq and Afghanistan.
Of the 5,410 participants, 395 (7.3%) had new-onset PTSD symptoms or diagnosis at the time of follow-up. After adjusting for all other variables, individuals with the lowest baseline mental or physical health scores had two to three times the risk of developing symptoms or a diagnosis of post-traumatic stress disorder by follow-up compared with those with higher scores.
Of those with new onset symptoms or diagnosis, over half (58%) of cases occurred among those with the lowest health scores at baseline. These participants were more likely to be female, younger, less educated, not married, current smokers, problem drinkers, and enlisted.
Despite some limitations, this study shows that diminished mental or physical health status before combat deployment is strongly associated with an increased risk of PTSD after deployment, they write.
In theory, those at risk could be targeted for PTSD prevention programs, early intervention after exposure to stress, or even protection from stressful exposures, when possible. Further research is also needed to develop effective screening tools and programs to prevent PTSD, they conclude.