Mental disorder most common medical diagnosis in military personnel just before separation, Pentagon study finds

Just before separating from the military, the most common medical diagnosis for the military was mental health disorders, according to a new study. Mental disorders, hardly ever diagnosed at the start of military service, became the first category of diagnosis at the end. ()

Just before separating from the military, the most common medical diagnosis for the military was mental health disorders, according to a new study.  Mental disorders, hardly ever diagnosed at the start of military service, became the first category of diagnosis at the end.

Just before separating from the military, the most common medical diagnosis for the military was mental health disorders, according to a new study. Mental disorders, hardly ever diagnosed at the start of military service, became the first category of diagnosis at the end. ()

Just before separating from the military, the most common medical diagnosis for the military was mental health disorders, according to a new study.  Mental disorders, hardly ever diagnosed at the start of military service, became the first category of diagnosis at the end.

Just before separating from the military, the most common medical diagnosis for the military was mental health disorders, according to a new study. Mental disorders, hardly ever diagnosed at the start of military service, became the first category of diagnosis at the end. (JD Strong II / US Air Force i)

They caught a cold at training camp. Mid-career they were beset with muscle tension, tears and back problems. But in the end, just before separating from the military, the military’s most common medical diagnosis was mental health disorders, according to a new Pentagon study.

Mental disorders – hardly ever diagnosed at the start of military service – became the main diagnostic category at the end, according to the Defense Health Agency study, which interviewed 45,000 soldiers who served from 4 to 15 years from from 2000 and separated in 2014 and 2015.

The study, published in the June edition of the Medical Surveillance Monthly Report, hypothesized that the increase in mental health diagnoses over time may be due in part to “many unique stressors,” including including combat deployments, frequent travel, long hours and absences. of the family. The fact that diagnoses of mental disorders increased upon separation could also be due to the negative impact such a diagnosis is likely to have on a member’s career.

Is Serving in the Army Harmful to Mental Health?

“It’s a possible conclusion, but probably not the best,” said Dr Harold Kudler, psychiatrist and professor at Duke University who recently retired as chief consultant for the ministry’s mental health services. of Veterans Affairs.

“I think the best conclusion is that we select healthy young people and then expose them to significant stressors over time, the wear and tear of being human beings facing the real challenges of service. military.”

Kudler told Stars and Stripes that the data reflected a number of phenomena, including a growing acceptance in recent years that mental health issues are common and that reporting them and seeking care is no shame.

“If you go back to it not that long ago, there was a strong feeling that (post-traumatic stress disorder) was something that happened to weak people. This has really changed over the years from a strong social stigma to something more akin to occupational hazard, which can affect a significant proportion of the military, ”said Kudler, who was not involved in the event. ‘study.

Another likely factor is timing and motivation. Early to mid-career troops are “a deterrent to reporting health problems or seeking treatment,” study authors, Air Force medic Captain Colby Uptegraft, and Shauna Stahlman said, epidemiologist in the health surveillance branch of the armed forces. These included the possibility of adverse staff actions such as medical assessment boards and subsequent medical separation, limitations of place of duty or deployment, and refusal or termination of career in the field, in particular in professions such as aviation and special forces.

But when military members are on the verge of separation, having medical diagnoses on their records, including for mental health issues, makes them eligible for VA and disability benefits.

“I think one thing we’re looking at is a sharp change in motivation to talk about these things as we approach separation from the military,” Kudler said.

The study aimed to track illnesses over time in the separation of troops – the 83 percent of troops who leave service before retirement at age 20 or older.

He looked for trends in what went up, down, or stayed roughly the same by looking at electronic health records at three career intervals: the first six months of service, the middle six months, and the last six months before. the separation.

The majority of the troops in the study – 72 percent – had served four to eight years; 22 percent had served eight to 12 years and 6 percent had served up to 15 years.

Most were male, white soldiers between the ages of 25 and 34. A third were Marines, and more than half were enlisted juniors and had never been deployed.

Initially, the majority of diagnoses were respiratory infections, which subsequently declined. Mental health disorders accounted for 1.3 percent of diagnoses.

By the midpoint of six months on duty, musculoskeletal problems made up almost a quarter of all medical diagnoses, and mental health diagnoses had climbed to 17%.

In the last six months of service, mental health diagnoses were the most common, accounting for almost 36% for men.

The study appears to be one of the first to analyze the medical diagnoses over time of people who left services before retirement.

Studies of retirees published in 2010 found a significant increase in the incidence rates of illness and injury diagnoses within six months of retirement; 72 percent of retirees were diagnosed with a new medical condition within six months of retirement. But few of them concerned mental health issues, according to this study.

The potential reasons for this “stark difference” between the two groups could be due to the fact that the troops arriving at retirement “are probably among the healthiest members of the service over time,” the authors wrote. study. In addition, their study did not distinguish between military personnel who separate voluntarily and those who are separated for medical reasons. “Many mental health problems, especially those that last longer than a year, require treatment and / or impact on the job, do not meet retention standards, and mental health disorders have been shown to be the main category of discharge diagnoses in men and the second category in women.

The present study found that musculoskeletal disorders peaked at 24.3 percent of diagnoses during the average monitoring period for men, but peaked at 23.4 percent in the first six months of service. for women.

Kudler said the study reflected “an evolving understanding that mental health problems are so prevalent in the general population,” particularly among those under stress.

“Depression and anxiety – they’re part of normal human life,” he said. “They are not always diseases. If you are in a room with a tiger and you are anxious, there is nothing wrong with that.

[email protected]Twitter: @montgomerynance

portrait of the author

Nancy Montgomery

Nancy is an Italy-based reporter for Stars and Stripes who writes on military health, legal and social issues. A native of upstate New York who served three years in the United States Army before graduating from the University of Arizona, she previously worked for The Anchorage Daily News and The Seattle Times. Over the course of her nearly 40-year journalistic career, she has won several regional and national awards for her stories and was part of a newsroom-wide team of the Anchorage Daily News that received the award. Civil Service Pulitzer in 1989.



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