Article

OBJECTIVES: To determine the association between specific military deployment
experiences and immediate and longer-term physical and mental health effects, as
well as examine the effects of multiple deployment-related traumatic brain
injuries (TBIs) on health outcomes. DESIGN:
Online survey of cross-sectional
cohort. Odds ratios were calculated to assess the association between
deployment-related factors (ie, physical injuries, exposure to potentially
traumatic deployment experiences, combat, blast exposure, and mild TBI) and
current health status, controlling for potential confounders, demographics, and
predeployment experiences. SETTING: Nonclinical. PARTICIPANTS:
Members (N=3098)
of the Florida National Guard (1443 deployed, 1655 not deployed). INTERVENTIONS:
Not applicable. MAIN OUTCOME MEASURES: Presence of current psychiatric diagnoses
and health outcomes, including postconcussive and non-postconcussive symptoms.
RESULTS: Surveys were completed an average of 31.8 months (SD=24.4, range=0-95)
after deployment. Strong, statistically significant associations were found
between self-reported military deployment-related factors and current adverse
health status. Deployment-related mild TBI was associated with depression,
anxiety, posttraumatic stress disorder (PTSD), and postconcussive symptoms
collectively and individually. Statistically significant increases in the
frequency of depression, anxiety, PTSD, and a postconcussive symptom complex were
seen comparing single to multiple TBIs. However, a predeployment TBI did not
increase the likelihood of sustaining another TBI in a blast exposure.
Associations between blast exposure and abdominal pain, pain on deep breathing,
shortness of breath, hearing loss, and tinnitus suggested residual barotrauma.
Combat exposures with and without physical injury were each associated not only
with PTSD but also with numerous postconcussive and non-postconcussive symptoms.
The experience of seeing others wounded or killed or experiencing the death of a
buddy or leader was associated with indigestion and headaches but not with
depression, anxiety, or PTSD. CONCLUSIONS: Complex relationships exist between
multiple deployment-related factors and numerous overlapping and co-occurring
current adverse physical and psychological health outcomes. Various
deployment-related experiences increased the risk for postdeployment adverse
mental and physical health outcomes, individually and in combination. These
findings suggest that an integrated physical and mental health care approach
would be beneficial to postdeployment care.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS