10 The baseline enrolment ended with 36% of personnel invited consenting to participate in the 21 year study. The unique nature of the millennium cohort study allows the investigation of both personnel on active duty and Reserve/National Guard members who have remained in military service or who have separated from the military after returning from deployment.īetween July 2001 and June 2003 the first panel of participants in the millennium cohort study, a population based US military cohort of 77 047 active military duty and Reserve/National Guard personnel, was enrolled in a 22 year longitudinal study of health. The objective of this study was to prospectively investigate the effect of military deployment and self reported exposure to combat on new onset and persistent symptoms of post-traumatic stress disorder in a large population based US military cohort. Prospective investigation of the causes of the disorder in large, population based military cohorts has been limited. 1 2 4 5 6 7 8 9 Epidemiological studies to date have largely focused on retrospective data or select groups. Symptoms of post-traumatic stress disorder have been reported in as many as 30% of veterans after service in Vietnam and in more than 10% of US military personnel returning from the 1991 Gulf war. 1 Combat duty in Iraq has been associated with high use of mental health services and attrition from military service and possible alterations in neural functioning after deployment. A recent report suggested that US marine and army infantry units returning from duty in Iraq and Afghanistan have higher than expected proportions of mental disorders and that as many as 10% of personnel are returning home with symptoms of post-traumatic stress disorder. Concern is growing among the public and veterans that post-deployment health consequences among US military personnel may be considerable and lasting. The findings define the importance of post-traumatic stress disorder in this population and emphasise that specific combat exposures, rather than deployment itself, significantly affect the onset of symptoms of post-traumatic stress disorder after deployment.įor more than five years the US military has been engaged in a combat intensive deployment in Iraq, Afghanistan, and neighbouring countries. Among those with self reported symptoms of post-traumatic stress disorder at baseline, deployment did not affect persistence of symptoms.Ĭonclusions After adjustment for baseline characteristics, these prospective data indicate a threefold increase in new onset self reported post-traumatic stress disorder symptoms or diagnosis among deployed military personnel who reported combat exposures. New onset self reported post-traumatic stress disorder symptoms or diagnosis were identified in 7.6-8.7% of deployers who reported combat exposures, 1.4-2.1% of deployers who did not report combat exposures, and 2.3-3.0% of non-deployers. New incidence rates of 10-13 cases of post-traumatic stress disorder per 1000 person years occurred in the millennium cohort. Results More than 40% of the cohort were deployed between 20 between baseline and follow-up, 24% deployed for the first time in support of the wars in Iraq and Afghanistan. Main outcome measures Self reported post-traumatic stress disorder as measured by the posttraumatic stress disorder checklist-civilian version using Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria. Follow-up (June 2004 to February 2006) data on health outcomes collected from 50 184 participants. Setting and participants Survey enrolment data from the millennium cohort (July 2001 to June 2003) obtained before the wars in Iraq and Afghanistan. Objective To describe new onset and persistence of self reported post-traumatic stress disorder symptoms in a large population based military cohort, many of whom were deployed in support of the wars in Iraq and Afghanistan.
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