Military stress disorder linked to previous poor health

Rates of post-traumatic stress disorder are highest among military personnel who had mental or physical health problems before combat, researchers reported today.

Researchers set out to see whether risk can be predicted. Cynthia LeardMann and colleagues at the Naval Health Research Centre in San Diego, USA, measured “functional health status” before and after combat exposure among 5,410 US military personnel.

On the website of the British Medical Journal, they write that the disorder was determined by either meeting the standard DSM-IV criteria or receiving a doctor’s diagnosis. Of the participants, 395 (7.3 per cent) developed PTSD.

Those who were rated in the lowest 15th centile for mental or physical health at baseline “had two to three times the risk of symptoms or a diagnosis of PTSD” at the time of follow-up compared with the other participants.

Over half (58 per cent) of the new PTSD cases arose in participants with health scores in the lowest 15th centile. These individuals were more likely to be women, younger, less educated, not married, current smokers, problem drinkers, and enlisted.

The authors conclude: “Low mental or physical health status before combat exposure significantly increases the risk of symptoms or diagnosis of post-traumatic stress disorder after deployment.

“More vulnerable members of a population could be identified and benefit from interventions targeted to prevent new onset posttraumatic stress disorder,” they suggest.

These could include early help after exposure to stress, or protection from stressful exposures when possible. The team add that further research is needed to develop better interventions and screening tests.

LeardMann, C. A. et al. Baseline self reported functional health and vulnerability to post-traumatic stress disorder after combat deployment: prospective US military cohort study. The British Medical Journal, 2009;338:b1273.