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Association Between Number of Deployments to Iraq and Mental Health Screening Outcomes in US Army Soldiers

J Clin Psychiatry 2009;70(9):1266-1272
10.4088/JCP.08m04361

Objective: High rates of mental health concerns have been documented in US Army soldiers deployed in support of Operation Iraqi Freedom. The goal of this study was to compare the postdeployment mental health screening results of US Army soldiers with 1 or 2 deployments to Iraq.

Method: Routine mental health screening data collected from September 7, 2005, to April 27, 2007, in the Soldier Wellness Assessment Program were compared between soldiers evaluated after their first or second deployment to Iraq (n=1322). Standardized measures (Primary Care Evaluation of Mental Disorders Patient Health Questionnaire, Primary Care Posttraumatic Stress Disorder Screen, Alcohol Use Disorders Identification Test) were used to screen for posttraumatic stress disorder (PTSD), panic, other anxiety, major depression, other depression, and hazardous alcohol consumption 90 to 180 days after the soldiers returned from Iraq.

Results: There was a significant association between number of deployments and mental health screening results such that soldiers with 2 deployments showed greater odds of screening positive for PTSD (odds ratio [OR]=1.64, P=.001). Similar results were observed when the analyses were repeated utilizing a more conservative cut-point for PTSD (OR=1.60, P=.001). After adjustment for demographic characteristics, the results were unchanged. There was no association between the number of deployments and other mental health screening results.

Conclusions: These results provide preliminary evidence that multiple deployments to Iraq may be a risk factor for PTSD. However, these cross-sectional data require replication in a longitudinal study.


Submitted: May 7, 2008; accepted September 17, 2008.

Online ahead of print: August 11, 2009.

Corresponding author: Gregory A. Gahm, PhD, National Center for Telehealth & Technology, Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, Tacoma, WA 98431-1100 (e-mail: gregory.gahm@us.army.mil).