Prolonged deployment was associated with more mental health diagnoses among US Army wives, according to a recent study published in The New England Journal of Medicine.
For the study, researchers studied electronic medical-record data for outpatient care received between 2003 and 2006 by 250,626 wives of active-duty US Army soldiers. They compared mental health diagnoses according to the number of months of deployment in the Iraq-Kuwait region and Afghanistan during the same period.
Among spouses of military members who were deployed, as compared with spouses of those who were not deployed, the rates of diagnoses associated with 1 to 11 months and more than 11 months of deployment were 18 to 24 percent higher for depressive disorders, 21 to 40 percent higher for sleep disorders, 25 to 29 percent higher for anxiety disorders and 23 to 39 higher for acute stress reaction and adjustment disorders.
Also, the rate of use of mental health services for any mental health diagnosis was 19 percent higher for spouses of military members who were deployed for 1 to 11 months, and 27 percent higher among spouses of military members who were deployed more than 11 months, compared with spouses of military members who were not deployed during the 2003 to 2006 period.
The report’s findings indicate that “prolonged periods of deployment for these operations [in Iraq and Afghanistan] were associated with an increased risk of mental health diagnoses and increased visits for these diagnoses among wives of Army soldiers.” In addition, the increase in risk was most apparent for depressive, anxiety, sleep, and acute stress reaction and adjustment disorders. “Overall, our data suggest that the mental health effects of current operations are extending beyond soldiers and into their immediate families,” the report concluded.
According to the report, mental health research involving past warfare indicates that frequent or extended military deployment leads to increased stress, anxiety and depression among personnel and their families.
However, current wars in Iraq and Afghanistan differ from other US conflicts, and that’s because combat during the 1991 Gulf War ended quickly and with relatively few US casualties. “In contrast, current operations have involved the first sustained ground combat since the Vietnam War, followed by a period of insurgent attacks that regularly maim and kill service personnel,” the report read. Also, in the same number of months, nearly six times as many hostile deaths occurred during the Iraq war in the Iraq-Kuwait region as occurred as a result of the first Gulf War.
Studies show “considerable mental health problems” in a large proportion of US soldiers and Marines returning from Iraq and Afghanistan. Also, the report stated, “Besides fear for the safety of their loved ones, spouses of deployed personnel often face challenges of maintaining a household, coping as a single parent and experiencing marital strain due to a deployment-induced separation of an uncertain duration.”
In addition, studies examining the effects of deployment on spouses have shown increased rates of marital dissatisfaction, unemployment, divorce and declining emotional health, according to the report. However, much previous research was often limited to short deployment periods or limited combat operations.
“Increased stress among military family members before, during and after deployment is a potential mechanism for the development of mental health problems,” the report stated. “The association between stressful life events and the subsequent onset or recurrence of mental disorders, including depression, substance use and abuse, and bipolar disorder, is well documented, though not well studied in military families.”
In the study for the article, patients were 18 to 48 years old. Wives of Reserve and National Guard personnel were excluded. Also, researchers included only wives of military members who had been in active-duty service for at least five years as of January 1, 2007.
Diagnoses were classified into 1 of 17 categories: alcohol use; anxiety; bipolar disorder; delirium, dementia and other cognitive disorders; depression; dissociative disorder; drug use; impulse control disorder; pediatric behavioral disorder; personality disorder; psychotic disorder; sleep disorder; somatoform and factitious disorders; and four stress-related categories: acute stress reaction and adjustment disorder, neurotic disorder, post-traumatic stress disorder and other stress disorders.
The study covered 6.6 million outpatient visits by 250,626 wives, of whom 34.7 percent had at least one mental health diagnosis during the study period. Among women whose husbands were deployed during the study period, 36.6 percent had at least one mental health diagnosis, compared with 30.5 percent of women whose husbands were not deployed. “Depression, anxiety, sleep disorder, and acute stress reaction and adjustment disorder were the most common diagnoses in both groups, but the percentage of spouses with one or more diagnoses in these categories during the study period was lower among spouses of non-deployed personnel,” the report stated.
The report’s analysis didn’t include data on the soldiers’ mental health, which could affect the spouses’ knowledge and attitudes about psychiatric conditions and treatment. However, the report stated, “The stigma associated with seeking care for mental health concerns has been well documented among military personnel,” and “Spouses may share these concerns about stigma and avoid seeking care, in which case our results would underestimate mental health problems in the military beneficiary population.”
In conclusion, the report stated, “Military leaders go to great lengths to offer services and support to families of deployed personnel, given the duration of and hazards associated with current operations. Such action has probably mitigated the effect of deployment on the mental health of family members. Our findings provide support for increased efforts for mental health services for military family members.”