PMID- 29530906
OWN - NLM
STAT- MEDLINE
DCOM- 20180924
LR  - 20190202
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 8
IP  - 3
DP  - 2018 Mar 12
TI  - Influence of military component and deployment-related experiences on mental 
      disorders among Canadian military personnel who deployed to Afghanistan: a 
      cross-sectional survey.
PG  - e018735
LID - 10.1136/bmjopen-2017-018735 [doi]
LID - e018735
AB  - OBJECTIVE: The primary objective was to explore differences in mental health 
      problems (MHP) between serving Canadian Armed Forces (CAF) components (Regular 
      Force (RegF); Reserve Force (ResF)) with an Afghanistan deployment and to assess 
      the contribution of both component and deployment experiences to MHP using 
      covariate-adjusted prevalence difference estimates. Additionally, mental health 
      services use (MHSU) was descriptively assessed among those with a mental 
      disorder. DESIGN: Data came from the 2013 CAF Mental Health Survey, a 
      cross-sectional survey of serving personnel (n=72 629). Analyses were limited to 
      those with an Afghanistan deployment (population n=35 311; sampled n=4854). 
      Logistic regression compared MHP between RegF and ResF members. 
      Covariate-adjusted prevalence differences were computed. PRIMARY OUTCOME MEASURE: 
      The primary outcomes were MHP, past-year mental disorders, identified using the 
      WHO's Composite International Diagnostic Interview, and past-year suicide 
      ideation. RESULTS: ResF personnel were less likely to be identified with a 
      past-year anxiety disorder (adjusted OR (AOR)=0.72 (95% CI 0.58 to 0.90)), 
      specifically both generalised anxiety disorder and panic disorder, but more 
      likely to be identified with a past-year alcohol abuse disorder (AOR=1.63 (95% CI 
      1.04 to 2.58)). The magnitude of the covariate-adjusted disorder prevalence 
      differences for component was highest for the any anxiety disorder outcome, 2.8% 
      (95% CI 1.0 to 4.6); lower for ResF. All but one deployment-related experience 
      variable had some association with MHP. The 'ever felt responsible for the death 
      of a Canadian or ally personnel' experience had the strongest association with 
      MHP; its estimated covariate-adjusted disorder prevalence difference was highest 
      for the any (of the six measured) mental disorder outcome (11.2% (95% CI 6.6 to 
      15.9)). Additionally, ResF reported less past-year MHSU and more past-year 
      civilian MHSU. CONCLUSIONS: Past-year MHP differences were identified between 
      components. Our findings suggest that although deployment-related experiences 
      were highly associated with MHP, these only partially accounted for MHP 
      differences between components. Additional research is needed to further 
      investigate MHSU differences between components.
CI  - (c) Article author(s) (or their employer(s) unless otherwise stated in the text of 
      the article) 2018. All rights reserved. No commercial use is permitted unless 
      otherwise expressly granted.
FAU - Boulos, David
AU  - Boulos D
AD  - Directorate of Mental Health, Canadian Forces Health Services Group, Ottawa, 
      Ontario, Canada.
FAU - Fikretoglu, Deniz
AU  - Fikretoglu D
AD  - Defence Research and Development Canada, Toronto, Ontario, Canada.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20180312
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
SB  - IM
MH  - Adult
MH  - Adult Survivors of Child Abuse/*psychology/statistics & numerical data
MH  - Afghan Campaign 2001-
MH  - Canada/epidemiology
MH  - Combat Disorders/complications/epidemiology/*psychology
MH  - Cross-Sectional Studies
MH  - Depressive Disorder, Major
MH  - Female
MH  - Health Surveys
MH  - Humans
MH  - Male
MH  - *Mental Disorders/epidemiology
MH  - Military Personnel/*psychology/statistics & numerical data
MH  - Prevalence
MH  - Stress Disorders, Post-Traumatic/epidemiology/etiology/*psychology
MH  - Suicidal Ideation
MH  - Young Adult
PMC - PMC5857669
OTO - NOTNLM
OT  - anxiety disorders
OT  - mental health
OT  - military health
COIS- Competing interests: Both DB and DF report that they are employees of the 
      Canadian Department of National Defence and funding for this research came via 
      this federal government department.
EDAT- 2018/03/14 06:00
MHDA- 2018/09/25 06:00
PMCR- 2018/03/12
CRDT- 2018/03/14 06:00
PHST- 2018/03/14 06:00 [entrez]
PHST- 2018/03/14 06:00 [pubmed]
PHST- 2018/09/25 06:00 [medline]
PHST- 2018/03/12 00:00 [pmc-release]
AID - bmjopen-2017-018735 [pii]
AID - 10.1136/bmjopen-2017-018735 [doi]
PST - epublish
SO  - BMJ Open. 2018 Mar 12;8(3):e018735. doi: 10.1136/bmjopen-2017-018735.