Health outcomes associated with military deployment: mild traumatic brain injury, blast, trauma, and combat associations in the Florida National Guard.
OBJECTIVE
To determine the association between specific military deployment experiences and immediate and longer-term physical and mental health effects, as well as examine the effects of multiple deployment-related traumatic brain injuries (TBIs) on health outcomes.


METHODS
Online survey of cross-sectional cohort. Odds ratios were calculated to assess the association between deployment-related factors (ie, physical injuries, exposure to potentially traumatic deployment experiences, combat, blast exposure, and mild TBI) and current health status, controlling for potential confounders, demographics, and predeployment experiences.


METHODS
Nonclinical.


METHODS
Members (N=3098) of the Florida National Guard (1443 deployed, 1655 not deployed).


METHODS
Not applicable.


METHODS
Presence of current psychiatric diagnoses and health outcomes, including postconcussive and non-postconcussive symptoms.


RESULTS
Surveys were completed an average of 31.8 months (SD=24.4, range=0-95) after deployment. Strong, statistically significant associations were found between self-reported military deployment-related factors and current adverse health status. Deployment-related mild TBI was associated with depression, anxiety, posttraumatic stress disorder (PTSD), and postconcussive symptoms collectively and individually. Statistically significant increases in the frequency of depression, anxiety, PTSD, and a postconcussive symptom complex were seen comparing single to multiple TBIs. However, a predeployment TBI did not increase the likelihood of sustaining another TBI in a blast exposure. Associations between blast exposure and abdominal pain, pain on deep breathing, shortness of breath, hearing loss, and tinnitus suggested residual barotrauma. Combat exposures with and without physical injury were each associated not only with PTSD but also with numerous postconcussive and non-postconcussive symptoms. The experience of seeing others wounded or killed or experiencing the death of a buddy or leader was associated with indigestion and headaches but not with depression, anxiety, or PTSD.


CONCLUSIONS
Complex relationships exist between multiple deployment-related factors and numerous overlapping and co-occurring current adverse physical and psychological health outcomes. Various deployment-related experiences increased the risk for postdeployment adverse mental and physical health outcomes, individually and in combination. These findings suggest that an integrated physical and mental health care approach would be beneficial to postdeployment care.
Mental Health and Behavioral Sciences - Psychology Service, James A. Haley Veterans' Hospital, Tampa, FL 33612, USA. Rodney.Vanderploeg@va.gov
Rodney D
RD
Vanderploeg
Heather G
HG
Belanger
Ronnie D
RD
Horner
Andrea M
AM
Spehar
Gail
G
Powell-Cope
Stephen L
SL
Luther
Steven G
SG
Scott
D001007:Anxiety / Q000453:epidemiology / Q000523:psychology; D001753:Blast Injuries / Q000453:epidemiology* / Q000523:psychology; D001930:Brain Injuries / Q000453:epidemiology* / Q000523:psychology; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005431:Florida / Q000453:epidemiology; D006304:Health Status; D006801:Humans; D020407:Internet; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D008889:Military Personnel; D057566:Self Report; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology; D013997:Time Factors; D014481:United States