Reger Mark A, Gahm Gregory A, Swanson Robert D, Duma Susan J
National Center for Telehealth & Technology, Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, Tacoma, Washington 98431-1100, USA.
J Clin Psychiatry. 2009 Sep;70(9):1266-72. doi: 10.4088/JCP.08m04361. Epub 2009 Aug 11.
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.
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.
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.
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.
据记载，在部署以支持伊拉克自由行动的美国陆军士兵中，心理健康问题发生率很高。本研究的目的是比较部署到伊拉克1次或2次的美国陆军士兵的部署后心理健康筛查结果。
比较了2005年9月7日至2007年4月27日在士兵健康评估计划中收集的常规心理健康筛查数据，这些数据来自首次或第二次部署到伊拉克后接受评估的士兵（n = 1322）。使用标准化测量方法（精神障碍初级保健评估患者健康问卷、初级保健创伤后应激障碍筛查、酒精使用障碍识别测试）对士兵从伊拉克返回90至180天后的创伤后应激障碍（PTSD）、恐慌、其他焦虑、重度抑郁、其他抑郁和危险饮酒情况进行筛查。
部署次数与心理健康筛查结果之间存在显著关联，即有2次部署的士兵PTSD筛查呈阳性的几率更高（优势比[OR]=1.64，P = 0.001）。当使用更保守的PTSD切点重复分析时，观察到了类似结果（OR = 1.60，P = 0.001）。在对人口统计学特征进行调整后，结果不变。部署次数与其他心理健康筛查结果之间没有关联。
这些结果提供了初步证据，表明多次部署到伊拉克可能是PTSD的一个风险因素。然而，这些横断面数据需要在纵向研究中进行重复验证。
