An important minority -- 13.5% -- of Canadian Forces personnel who served in support of the Afghanistan mission in 2001-08 have been found to have a mental health disorder related to their deployment, according to a study published in CMAJ (Canadian Medical Association Journal).
Since 2001, more than 40 000 Canadian Forces personnel have been deployed in support of the Afghanistan mission. Although studies from other countries have shown mental health problems in personnel returning from missions in Southwest Asia, there are important differences between nations in areas such as military culture, experiences during deployment, and delivery of mental health service.
To better understand the psychological impact of the Afghanistan mission on Canadian Forces personnel, researchers conducted a study of all personnel -- 30 513 people -- who were deployed outside North America or Europe between Oct. 1, 2001 and Dec. 31, 2008. They identified a sample of 2014 individuals and reviewed their medical records to determine whether there was a diagnosis of mental disorder and a clinician's indication of a relation between the diagnosis and the Afghanistan deployment. The researchers used the DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision) definitions to determine a mental disorder.
Of the study population, which consisted mainly of men under age 40 in the Regular Forces, 13.5% were found to have a mental disorder (over a median follow-up of 1364 days) related to their Afghanistan deployment. Posttraumatic stress disorder (PTSD) was the most common mental disorder, found in 8% of personnel deployed in support of the Afghanistan mission, followed by depression in 6.3%. About 23% of those with depressive disorders were also suffering from PTSD. An additional 5.5% had a mental disorder judged to be unrelated to their Afghanistan deployment.
Locations within Afghanistan were associated with variable levels of mental disorders, with more dangerous locations resulting in higher risk of mental disorders.
"Deployment to Kandahar was associated with a particularly increased risk: it was almost 6 times the risk associated with deployment to the United Arab Emirates or Arabian Gulf and 2 times the risk associated with deployment to multiple locations or Kabul," writes Mr. David Boulos with Dr. Mark Zamorski, Directorate of Mental Health, Canadian Forces Health Services Group Headquarters, Ottawa.
As well, lower rank and service in the Army compared with Air Force or Navy increased the risk of mental disorders.
"This study provided a precise and methodologically rigorous estimate of the impact of the mission on the risk of mental disorders during continued military service," write the authors. "These findings will have implications in terms of service delivery and veterans' benefits. Future research with this cohort will explore the process and outcomes of the mental health care delivered to personnel with mental disorders related to the Afghanistan mission."