title: Do medical services personnel who deployed to the Iraq war have worse mental health than other deployed personnel?
abstract: OBJECTIVE
  There is evidence of increased health care utilization by medical personnel (medics) compared to other trades in the UK Armed Forces. The aim of this study was to compare the burden of mental ill health in deployed medics with all other trades during the Iraq war.
  
  
  METHODS
  Participants' main duty during deployment was identified from responses to a questionnaire and verified from Service databases. Psychological health outcomes included psychological distress, post-traumatic stress disorder, multiple physical symptoms, fatigue and heavy drinking.
  
  
  RESULTS
  A total of 479 out of 5824 participants had a medical role. Medics were more likely to report psychological distress (OR 1.30, 95% CI 1.00-1.70), multiple physical symptoms (OR 1.65, 95% CI 1.20-2.27) and, if men, fatigue (1.38, 95% CI 1.05-1.81) than other personnel. Female medics were less likely to report fatigue (0.57 95% CI 0.35-0.92). Neither post-traumatic stress disorder nor heavy drinking symptoms were associated with a medical role. Traumatic medical experiences, lower group cohesion and preparedness, and post-deployment experiences explained the positive associations with psychological ill health. Medics made greater use of medical facilities than other trades.
  
  
  CONCLUSIONS
  There is a small excess of psychological ill health in medics, which can be explained by poorer group cohesion, traumatic medical and post-deployment experiences. The association of mental ill health with a medical role was not the consequence of a larger proportion of reservists in this group.
authors.affiliation: King's Centre for Military Health Research, Institute of Psychiatry, King's College London, London, UK. margaret.jones@kcl.ac.uk
authors.forename: Margaret
authors.initials: M
authors.lastname: Jones
authors.forename: Nicola T
authors.initials: NT
authors.lastname: Fear
authors.forename: Neil
authors.initials: N
authors.lastname: Greenberg
authors.forename: Norman
authors.initials: N
authors.lastname: Jones
authors.forename: Lisa
authors.initials: L
authors.lastname: Hull
authors.forename: Matthew
authors.initials: M
authors.lastname: Hotopf
authors.forename: Simon
authors.initials: S
authors.lastname: Wessely
authors.forename: Roberto J
authors.initials: RJ
authors.lastname: Rona
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D054542:Iraq War, 2003-2011; D007857:Leadership; D008297:Male; D008603:Mental Health; D008889:Military Personnel / Q000523:psychology*; D012737:Sex Factors; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology; D013315:Stress, Psychological / Q000453:epidemiology; D006113:United Kingdom