title: Mental distress among younger veterans before, during, and after the invasion of Iraq.
abstract: OBJECTIVE
  The purpose of this study was to determine whether patients receiving care from the Department of Veterans Affairs (VA) reported more mental distress as the war in Iraq began or reintensified compared with other respondents to national health surveys.
  
  
  METHODS
  Data from the 2000 and 2003 Behavioral Risk Factor Surveillance System (BRFSS) health surveys were analyzed. Unlike in other years, these particular surveys asked respondents whether they were military veterans. As in other years' surveys, these surveys also asked whether respondents used VA medical care. Male respondents were stratified by age and separated into three groups: VA patients, other veterans, and nonveterans. The proportions of respondents who reported five or more recent days of poor mental or physical health were analyzed with chi square tests.
  
  
  RESULTS
  Although the number of recent days of poor mental health among nonveterans, other veterans, and older VA patients were stable from 2000 to 2003, younger VA patients in 2003 reported substantially more days of poor mental health in two intervals: during the Iraq war buildup and invasion, and later, when resistance on the ground reintensified. Comparable changes in physical health complaints were not observed.
  
  
  CONCLUSIONS
  In times of war, the VA may anticipate more mental health problems among its current patients, particularly younger veterans.
authors.affiliation: Department of Veterans Affairs (VA) Outcomes Group Research Enhancement Awards Program (REAP), VA National Center, White River Junction, Vermont 05009, USA. alan.west@med.va.gov
authors.forename: Alan N
authors.initials: AN
authors.lastname: West
authors.forename: William B
authors.initials: WB
authors.lastname: Weeks
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006306:Health Surveys; D006801:Humans; D007493:Iraq; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012307:Risk Factors; D012621:Seasons; D012919:Social Behavior; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology* / Q000628:therapy; D013997:Time Factors; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data*; D014857:Warfare