title: Deployment and the use of mental health services among U.S. Army wives.
abstract: BACKGROUND
  Military operations in Iraq and Afghanistan have involved the frequent and extended deployment of military personnel, many of whom are married. The effect of deployment on mental health in military spouses is largely unstudied.
  
  
  METHODS
  We examined electronic medical-record data for outpatient care received between 2003 and 2006 by 250,626 wives of active-duty U.S. Army soldiers. After adjustment for the sociodemographic characteristics and the mental health history of the wives, as well as the number of deployments of the personnel, we compared mental health diagnoses according to the number of months of deployment in Operation Iraqi Freedom in the Iraq-Kuwait region and Operation Enduring Freedom in Afghanistan during the same period.
  
  
  RESULTS
  The deployment of spouses and the length of deployment were associated with mental health diagnoses. In adjusted analyses, as compared with wives of personnel who were not deployed, women whose husbands were deployed for 1 to 11 months received more diagnoses of depressive disorders (27.4 excess cases per 1000 women; 95% confidence interval [CI], 22.4 to 32.3), sleep disorders (11.6 excess cases per 1000; 95% CI, 8.3 to 14.8), anxiety (15.7 excess cases per 1000; 95% CI, 11.8 to 19.6), and acute stress reaction and adjustment disorders (12.0 excess cases per 1000; 95% CI, 8.6 to 15.4). Deployment for more than 11 months was associated with 39.3 excess cases of depressive disorders (95% CI, 33.2 to 45.4), 23.5 excess cases of sleep disorders (95% CI, 19.4 to 27.6), 18.7 excess cases of anxiety (95% CI, 13.9 to 23.5), and 16.4 excess cases of acute stress reaction and adjustment disorders (95% CI, 12.2 to 20.6).
  
  
  CONCLUSIONS
  Prolonged deployment was associated with more mental health diagnoses among U.S. Army wives, and these findings may have relevance for prevention and treatment efforts.
authors.affiliation: Department of Epidemiology, University of North Carolina, Chapel Hill, USA. amansfield@rti.org
authors.forename: Alyssa J
authors.initials: AJ
authors.lastname: Mansfield
authors.forename: Jay S
authors.initials: JS
authors.lastname: Kaufman
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Marshall
authors.forename: Bradley N
authors.initials: BN
authors.lastname: Gaynes
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Morrissey
authors.forename: Charles C
authors.initials: CC
authors.lastname: Engel
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D000553:Ambulatory Care / Q000706:statistics & numerical data; D001008:Anxiety Disorders / Q000453:epidemiology; D003866:Depressive Disorder / Q000453:epidemiology; D005192:Family Health; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D001523:Mental Disorders / Q000453:epidemiology*; D008603:Mental Health; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D008889:Military Personnel; D012306:Risk; D012893:Sleep Wake Disorders / Q000453:epidemiology; D018454:Spouses / Q000523:psychology*; D013315:Stress, Psychological / Q000453:epidemiology*; D014481:United States; D014857:Warfare; D055815:Young Adult