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This Article Figures Only Full Text Full Text (PDF) Supplemental Data All Versions of this Article: AJPH.2008.150284v1 99/9/1651    most recent Submit a response View responses 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 HighWire Google Scholar Articles by Seal, K. H. Articles by Marmar, C. R. PubMed PubMed Citation Articles by Seal, K. H. Articles by Marmar, C. R. Related Collections Disability Epidemiology Alcohol

Karen H. Seal, MD, MPH, Thomas J. Metzler, MA, Kristian S. Gima, BA, Daniel Bertenthal, MPH, Shira Maguen, PhD and Charles R. Marmar, MD

All the authors are with the San Francisco VA Medical Center, San Francisco, CA. In addition, Karen H. Seal, Shira Maguen, and Charles R. Marmar are with the University of California, San Francisco.

Correspondence: Correspondence should be sent to Karen H. Seal, MD, MPH, San Francisco VA Medical Center, 1450 Clement St, Box 111A-1, San Francisco, CA 94121 (e-mail: Karen.Seal{at}va.gov). Reprints can be ordered at http://www.ajph.org by clicking the "Reprints/Eprints" link.

Objectives. We sought to investigate longitudinal trends and risk factors for mental health diagnoses among Iraq and Afghanistan veterans.

Methods. We determined the prevalence and predictors of mental health diagnoses among 289 328 Iraq and Afghanistan veterans entering Veterans Affairs (VA) health care from 2002 to 2008 using national VA data.

Results. Of 289 328 Iraq and Afghanistan veterans, 106 726 (36.9%) received mental health diagnoses; 62 929 (21.8%) were diagnosed with posttraumatic stress disorder (PTSD) and 50 432 (17.4%) with depression. Adjusted 2-year prevalence rates of PTSD increased 4 to 7 times after the invasion of Iraq. Active duty veterans younger than 25 years had higher rates of PTSD and alcohol and drug use disorder diagnoses compared with active duty veterans older than 40 years (adjusted relative risk = 2.0 and 4.9, respectively). Women were at higher risk for depression than were men, but men had over twice the risk for drug use disorders. Greater combat exposure was associated with higher risk for PTSD.

Conclusions. Mental health diagnoses increased substantially after the start of the Iraq War among specific subgroups of returned veterans entering VA health care. Early targeted interventions may prevent chronic mental illness.

This article has been cited by other articles:

				Mental Health Burden of Veterans Returning from Iraq and Afghanistan Journal Watch Psychiatry, September 21, 2009; 2009(921): 2 - 2. [Full Text]

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