Increased probable PTSD among British veterans

A new study from King's College London suggests that the conflicts in Iraq and Afghanistan may have resulted in an increase in the rate of post-traumatic stress disorder (PTSD) likely among members of the British Armed Forces.

The results, published in the British Journal of Psychiatry Today, the overall rate of probable PTSD among current and former military personnel in 2014/16 is estimated at 6%, compared to 4% in 2004/6. The study also revealed that the rate of alcohol abuse had increased from 15% in 2004/2006 to 10% in 2014/16.

Large-scale studies exclude individual clinical assessments of PTSD. Therefore, participants were considered to have probable PTSD if they scored 50 or higher on the PTSD checklist questionnaire, in accordance with international research standards.

The increase in probable PTSD rates mainly concerns the former service personnel deployed in Iraq and Afghanistan. Among those deployed in the conflict, the probable rate of PTSD among veterans was 9%, compared to 5% among veterans who did not deploy. The probable rate of PTSD among current staff was also 5%, which is close to the rate of PTSD in the general population.

The lead author, Dr. Sharon Stevelink of the Institute of Psychiatry, Psychology and Neuroscience (IoPPN), said, "For the first time, we found that the risk of post-traumatic stress in veterans deployed in conflict was significantly higher than that of the. Although the increase among veterans is a matter of concern, not all veterans have been deployed and, in general, only about one in three would have been deployed in a combat role.

Of the former staff members who served in Iraq or Afghanistan in combat, 17% reported symptoms suggestive of probable PTSD, compared with 6% of those deployed in support functions such as doctors, logistics, communications and the flight crew.

The findings come from the third phase of a major cohort study conducted by the King & # 39; s Military Health Research Center, ongoing since 2003 and funded by the Department of Defense. Of the 8093 participants included in the third phase of the study, 62% were deployed in Iraq or Afghanistan.

Professor Nicola Fear of IoPPN, lead author, said, "In previous phases of the study, the probable rates of PTSD in our military sample were broadly similar to those in the general population, but they now appear to have increased. Further research is needed to explain this increase, but one of the possible reasons for the prevalence of PTSD among veterans may be that staff with mental disorders are more likely to leave the workforce. armed forces ".

The study also found that the rate of common mental disorders was 31% for veterans who played a role in combat, compared to 22% overall. However, the overall rate of common mental disorders has not increased compared to previous phases of the study. PTSD remains less prevalent in the military than alcohol abuse or common mental disorders.

Professor Sir Simon Wessely, senior author, Professor of Regius Psychiatry at King's College London, said, "Our findings suggest that the risk of mental illness is borne by those who have left the service, and that it is not the same. Part of the inheritance of mental health conflicts has taken time to reveal itself. However, it would be wrong to say that there is an "arc wave", a "tsunami" or a "time bomb" of PTSD in the military community and British veterans. The study confirms the current goal of providing and improving mental health services for serving staff and veterans.

Professor Wendy Burn, President of the Royal College of Psychiatrists, said, "It is essential to respond to the growing demand for military and veterans mental health services so that those who serve their country have easy access to care during their service. and after their service. Fortunately, more soldiers are asking for the care they need. The results of this article highlight the vital role military psychiatrists, both uniformed and civilian, play in protecting the mental health of military members, and the fact that working in this field can be extremely rewarding and exciting work. "

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More information:
Sharon A. M. Stevelink et al. Results of Mental Health at the End of British Engagement in the Conflicts in Iraq and Afghanistan: A Cohort Study, The British Journal of Psychiatry (2018). DOI: 10.1192 / bjp.2018.175