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This Article Full Text Full Text (PDF) Data Supplement All Versions of this Article: AJPH.2008.134205v1 98/12/2191    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Sareen, J. Articles by Stein, M. B. Search for Related Content PubMed PubMed Citation Articles by Sareen, J. Articles by Stein, M. B. Related Collections Disability Epidemiology Mental Health Occupational Health Surveys

Jitender Sareen, MD, FRCPC, Shay-Lee Belik, MSc, Tracie O. Afifi, MSc, Gordon J. G. Asmundson, PhD, Brian J. Cox, PhD and Murray B. Stein, MD, MPH, FRCPC

Jitender Sareen, Shay-Lee Belik, and Tracie O. Afifi are with the Departments of Psychiatry and Community Health Sciences, University of Manitoba, Winnipeg. Gordon J. G. Asmundson is with the Anxiety and Illness Behaviours Laboratory, University of Regina, Regina, Saskatchewan. Brian J. Cox is with the Departments of Psychiatry, Psychology, and Community Health Sciences at the University of Manitoba, Winnipeg. Murray B. Stein is with Departments of Psychiatry, Family, and Preventive Medicine, University of California, San Diego, La Jolla, CA.

Correspondence: Requests for reprints should be sent to Jitender Sareen, MD, PZ430-771 Bannatyne Ave, Winnipeg, Manitoba, R3E 3N4, Canada (e-mail: sareen{at}cc.umanitoba.ca).

Objectives. We investigated mental disorders, suicidal ideation, self-perceived need for treatment, and mental health service utilization attributable to exposure to peacekeeping and combat operations among Canadian military personnel.

Methods. With data from the Canadian Community Health Survey Cycle 1.2 Canadian Forces Supplement, a cross-sectional population-based survey of active Canadian military personnel (N = 8441), we estimated population attributable fractions (PAFs) of adverse mental health outcomes.

Results. Exposure to either combat or peacekeeping operations was associated with posttraumatic stress disorder (men: PAF = 46.6%; 95% confidence interval [CI] = 27.3, 62.7; women: PAF = 23.6%; 95% CI = 9.2, 40.1), 1 or more mental disorder assessed in the survey (men: PAF = 9.3%; 95% CI = 0.4, 18.1; women: PAF = 6.1%; 95% CI = 0.0, 13.4), and a perceived need for information (men: PAF = 12.3%; 95% CI = 4.1, 20.6; women: PAF = 7.9%; 95% CI = 1.3, 15.5).

Conclusions. A substantial proportion, but not the majority, of mental health–related outcomes were attributable to combat or peacekeeping deployment. Future studies should assess traumatic events and their association with physical injury during deployment, premilitary factors, and postdeployment psychosocial factors that may influence soldiers’ mental health.