title: The prevalence of mental health disorders in (ex-)military personnel with a physical impairment: a systematic review.
abstract: BACKGROUND
  Having a visual, hearing or physical impairment (defined as problems in body function or structure) may adversely influence the mental well-being of military personnel. This paper reviews the existing literature regarding the prevalence of mental health problems among (ex-)military personnel who have a permanent, predominantly, physical impairment.
  
  
  METHODS
  Multiple electronic literature databases were searched for relevant studies (EMBASE (1980-January 2014), MEDLINE (1946-January 2014), PsycINFO (2002-January 2014), Web of Science (1975-January 2014)).
  
  
  RESULTS
  25 papers were included in the review, representing 17 studies. Studies conducted among US military personnel (n=8) were most represented. A range of mental health disorders were investigated; predominately post-traumatic stress disorder (PTSD), but also depression, anxiety disorder (excluding PTSD), psychological distress and alcohol misuse. The findings indicate that mental health disorders including PTSD (range 2-59%), anxiety (range 16.1-35.5%), depression (range 9.7-46.4%) and psychological distress (range 13.4-36%) are frequently found whereby alcohol misuse was least common (range 2.2-26.2%).
  
  
  CONCLUSIONS
  Common mental health disorders were frequently identified among (ex-)military personnel with a physical impairment. Adequate care and support is necessary during the impairment adaptation process to facilitate the psychosocial challenges (ex-)military personnel with an impairment face. Future research should be directed into factors impacting on the mental well-being of (ex-)military personnel with an impairment, how prevalence rates vary across impairment types and to identify and act on specific needs for care and support.
authors.affiliation: Department of Psychological Medicine, King's Centre for Military Health Research, King's College London, London, UK.
authors.forename: S A M
authors.initials: SA
authors.lastname: Stevelink
authors.affiliation: Department of Psychological Medicine, King's Centre for Military Health Research, King's College London, London, UK.
authors.forename: E M
authors.initials: EM
authors.lastname: Malcolm
authors.affiliation: Department of Psychological Medicine, King's Centre for Military Health Research, King's College London, London, UK.
authors.forename: C
authors.initials: C
authors.lastname: Mason
authors.affiliation: Department of Psychological Medicine, King's Centre for Military Health Research, King's College London, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Jenkins
authors.affiliation: Academic Department of Defence Mental Health, Department of Psychological Medicine, King's College London, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Sundin
authors.affiliation: Department of Psychological Medicine, King's Centre for Military Health Research, King's College London, London, UK Academic Department of Defence Mental Health, Department of Psychological Medicine, King's College London, London, UK.
authors.forename: N T
authors.initials: NT
authors.lastname: Fear
mesh_terms: D006233:Persons with Disabilities / Q000523:psychology*; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D014728:Veterans / Q000523:psychology*
keywords: anxiety; depression; disability; military; post-traumatic stress disorder