Contribution of the Mission in Afghanistan to the Burden of Past-Year Mental Disorders in Canadian Armed Forces Personnel, 2013

• Published in: Canadian journal of psychiatry Vol. 61; no. 1_suppl; pp. 64S - 76S
• Main Authors: Boulos, David, Zamorski, Mark A.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-04-2016
• Subjects: Adolescent; Adult; Adult Survivors of Child Abuse - statistics & numerical data; Afghan Campaign 2001; Alcoholism - epidemiology; Alcoholism - etiology; Canada - epidemiology; Combat Disorders - complications; Combat Disorders - epidemiology; Female; Health Surveys - statistics & numerical data; Humans; Male; Middle Aged; Military Personnel - statistics & numerical data; Original Research; Panic Disorder - epidemiology; Panic Disorder - etiology; Stress Disorders, Post-Traumatic - epidemiology; Stress Disorders, Post-Traumatic - etiology; Suicidal Ideation; Young Adult; epidemiology; Afghanistan service-related mental disorders; military personnel; mental disorders; population attributable fraction
• ISSN: 0706-7437; 1497-0015
• DOI: 10.1177/0706743716628857

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.