Article title: Contribution of the Mission in Afghanistan to the Burden of Past-year Mental Disorders in Canadian Armed Forces Personnel, 2013
Among the mental health disorders reported in the Canadian Armed Forces (CAF) in 2013, 8.7% of the burden of illness was attributed to Afghanistan-related military service while 28.7% was attributed to past child abuse experiences.
Examining the 2013 Canadian Forces Mental Health Survey (CFMHS), which includes data from 6,696 fulltime personnel, this study found:
- 18.4% of respondents who were deployed to Afghanistan reported that in 2012, they had significant symptoms of one or more of the following six common mental disorders: generalized anxiety disorder, panic disorder, thoughts about suicide, post-traumatic stress disorder, alcohol abuse or dependence, or had experienced a major depressive episode.
- Respondents that were deployed to Afghanistan were 2.4% more likely to have experienced child abuse than those that were not deployed to Afghanistan.
- The Afghanistan-related deployments accounted for 34.7% of the burden of panic disorder, 32.1% of post-traumatic stress disorder, and 9.3% of major depression.
- Child abuse accounted for 48.4% of the cases of alcohol dependency, 37.1 % of post-traumatic stress disorders, and 33.8% of the cases of suicidal ideation.
- Together, Afghanistan-related deployments and child abuse experiences accounted for 38% of any mental disorder, 58.5% of post-traumatic stress disorders, 51.4% of panic disorders, and 37% of major depressive episodes.“Our findings indicate that a significant proportion of past-year mental disorders in the CAF, particularly post-traumatic stress disorder and panic disorder, were attributed to Afghanistan-related deployments,” wrote Boulos and Zamorski. “However, the contribution from child abuse experiences was much larger. These findings speak to the need for robust mental health systems that target the full range of determinants of mental health in military personnel, both in times of war and in times of peace.”
Objective: The purpose of this study was to estimate the contribution of the mission in Afghanistan to the burden of mental health problems in the Canadian Armed Forces (CAF).
Methods: Data were obtained from the 2013 Canadian Forces Mental Health Survey, which assessed mental disorders using the World Health Organization’s Composite International Diagnostic Interview. The sample consisted of 6696 Regular Force (RegF) personnel, 3384 of whom had deployed in support of the mission. We estimated the association of past-year mental health problems with Afghanistan deployment status, adjusting for covariates using logistic regression; population attributable fractions (PAFs) were also calculated.
Results: Indication of a past-year mental disorder was identified in 18.4% (95% confidence interval [CI], 17.0% to 19.7%) of Afghanistan deployers compared with 14.6% (95% CI, 13.3% to 15.8%) in others. Afghanistan-related deployments contributed to the burden of a past-year disorder (PAF = 8.7%; 95% CI, 3.0% to 14.2%), with the highest PAFs being seen for panic disorder (34.7%) and posttraumatic stress disorder (32.1%). The PAFs for individual alcohol use disorders and suicide ideation were not different from zero. Child abuse, however, had a much greater PAF for any past-year disorder (28.7%; 95% CI, 23.4% to 33.7%) than did the Afghanistan mission.
Conclusions: The mission in Afghanistan contributed significantly to the burden of mental disorders in the CAF RegF in 2013. However, the much stronger contribution of child abuse highlights the need for strong military mental health systems, even in peacetime, and the need to target the full range of determinants of mental health in prevention and control efforts.
David Boulos and Mark A. Zamorski
Contribution of the Mission in Afghanistan to the Burden of Past-Year Mental Disorders in Canadian Armed Forces Personnel, 2013
Can J Psychiatry April 2016 61: 64S-76S, doi:10.1177/0706743716628857