title: What are the effects of having an illness or injury whilst deployed on post deployment mental health? A population based record linkage study of UK army personnel who have served in Iraq or Afghanistan.
abstract: BACKGROUND
  The negative impact of sustaining an injury on a military deployment on subsequent mental health is well-documented, however, the relationship between having an illness on a military operation and subsequent mental health is unknown.
  
  
  METHODS
  Population based study, linking routinely collected data of attendances at emergency departments in military hospitals in Iraq and Afghanistan [Operational Emergency Department Attendance Register (OpEDAR)], with data on 3896 UK Army personnel who participated in a military health study between 2007 and 2009 and deployed to Iraq or Afghanistan between 2003 to 2009.
  
  
  RESULTS
  In total, 13.8% (531/3896) of participants had an event recorded on OpEDAR during deployment; 2.3% (89/3884) were medically evacuated. As expected, those medically evacuated for an injury were at increased risk of post deployment probable PTSD (odds ratio 4.27, 95% confidence interval 1.80-10.12). Less expected was that being medically evacuated for an illness was also associated with a similarly increased risk of probable PTSD (4.39, 1.60-12.07) and common mental disorders (2.79, 1.41-5.51). There was no association between having an OpEDAR event and alcohol misuse. Having an injury caused by hostile action was associated with increased risk of probable PTSD compared to those with a non-hostile injury (3.88, 1.15 to 13.06).
  
  
  CONCLUSIONS
  Personnel sustaining illnesses on deployment are just as, if not more, at risk of having subsequent mental health problems as personnel who have sustained an injury. Monitoring of mental health problems should consider those with illnesses as well as physical injuries.
authors.affiliation: London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
authors.forename: Harriet J
authors.initials: HJ
authors.lastname: Forbes
authors.forename: Norman
authors.initials: N
authors.lastname: Jones
authors.forename: Charlotte
authors.initials: C
authors.lastname: Woodhead
authors.forename: Neil
authors.initials: N
authors.lastname: Greenberg
authors.forename: Kate
authors.initials: K
authors.lastname: Harrison
authors.forename: Sandra
authors.initials: S
authors.lastname: White
authors.forename: Simon
authors.initials: S
authors.lastname: Wessely
authors.forename: Nicola T
authors.initials: NT
authors.lastname: Fear
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*; D006113:United Kingdom; D014728:Veterans / Q000523:psychology*