Among Army Wives
Friday 22 January 2010
by: Mary Susan Littlepage
Prolonged deployment was associated with more mental health diagnoses
among US Army wives, according to a recent study published in The New
England Journal of Medicine.
For the study, researchers studied electronic medical-record data for
outpatient care received between 2003 and 2006 by 250,626 wives of
active-duty US Army soldiers. They compared mental health diagnoses
according to the number of months of deployment in the Iraq-Kuwait
region and Afghanistan during the same period.
Among spouses of military members who were deployed, as compared with
spouses of those who were not deployed, the rates of diagnoses
associated with 1 to 11 months and more than 11 months of deployment
were 18 to 24 percent higher for depressive disorders, 21 to 40
percent higher for sleep disorders, 25 to 29 percent higher for
anxiety disorders and 23 to 39 higher for acute stress reaction and
adjustment disorders.
Also, the rate of use of mental health services for any mental health
diagnosis was 19 percent higher for spouses of military members who
were deployed for 1 to 11 months, and 27 percent higher among spouses
of military members who were deployed more than 11 months, compared
with spouses of military members who were not deployed during the
2003 to 2006 period.
The report's findings indicate that "prolonged periods of deployment
for these operations [in Iraq and Afghanistan] were associated with
an increased risk of mental health diagnoses and increased visits for
these diagnoses among wives of Army soldiers." In addition, the
increase in risk was most apparent for depressive, anxiety, sleep,
and acute stress reaction and adjustment disorders. "Overall, our
data suggest that the mental health effects of current operations are
extending beyond soldiers and into their immediate families," the
report concluded.
According to the report, mental health research involving past
warfare indicates that frequent or extended military deployment leads
to increased stress, anxiety and depression among personnel and their families.
However, current wars in Iraq and Afghanistan differ from other US
conflicts, and that's because combat during the 1991 Gulf War ended
quickly and with relatively few US casualties. "In contrast, current
operations have involved the first sustained ground combat since the
Vietnam War, followed by a period of insurgent attacks that regularly
maim and kill service personnel," the report read. Also, in the same
number of months, nearly six times as many hostile deaths occurred
during the Iraq war in the Iraq-Kuwait region as occurred as a result
of the first Gulf War.
Studies show "considerable mental health problems" in a large
proportion of US soldiers and Marines returning from Iraq and
Afghanistan. Also, the report stated, "Besides fear for the safety of
their loved ones, spouses of deployed personnel often face challenges
of maintaining a household, coping as a single parent and
experiencing marital strain due to a deployment-induced separation of
an uncertain duration."
In addition, studies examining the effects of deployment on spouses
have shown increased rates of marital dissatisfaction, unemployment,
divorce and declining emotional health, according to the report.
However, much previous research was often limited to short deployment
periods or limited combat operations.
"Increased stress among military family members before, during and
after deployment is a potential mechanism for the development of
mental health problems," the report stated. "The association between
stressful life events and the subsequent onset or recurrence of
mental disorders, including depression, substance use and abuse, and
bipolar disorder, is well documented, though not well studied in
military families."
In the study for the article, patients were 18 to 48 years old. Wives
of Reserve and National Guard personnel were excluded. Also,
researchers included only wives of military members who had been in
active-duty service for at least five years as of January 1, 2007.
Diagnoses were classified into 1 of 17 categories: alcohol use;
anxiety; bipolar disorder; delirium, dementia and other cognitive
disorders; depression; dissociative disorder; drug use; impulse
control disorder; pediatric behavioral disorder; personality
disorder; psychotic disorder; sleep disorder; somatoform and
factitious disorders; and four stress-related categories: acute
stress reaction and adjustment disorder, neurotic disorder,
post-traumatic stress disorder and other stress disorders.
The study covered 6.6 million outpatient visits by 250,626 wives, of
whom 34.7 percent had at least one mental health diagnosis during the
study period. Among women whose husbands were deployed during the
study period, 36.6 percent had at least one mental health diagnosis,
compared with 30.5 percent of women whose husbands were not deployed.
"Depression, anxiety, sleep disorder, and acute stress reaction and
adjustment disorder were the most common diagnoses in both groups,
but the percentage of spouses with one or more diagnoses in these
categories during the study period was lower among spouses of
non-deployed personnel," the report stated.
The report's analysis didn't include data on the soldiers' mental
health, which could affect the spouses' knowledge and attitudes about
psychiatric conditions and treatment. However, the report stated,
"The stigma associated with seeking care for mental health concerns
has been well documented among military personnel," and "Spouses may
share these concerns about stigma and avoid seeking care, in which
case our results would underestimate mental health problems in the
military beneficiary population."
In conclusion, the report stated, "Military leaders go to great
lengths to offer services and support to families of deployed
personnel, given the duration of and hazards associated with current
operations. Such action has probably mitigated the effect of
deployment on the mental health of family members. Our findings
provide support for increased efforts for mental health services for
military family members."
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