title: Factors associated with psychiatric evacuation among service members deployed to Operation Enduring Freedom and Operation Iraqi Freedom, January 2004 to September 2010.
abstract: OBJECTIVE
  To calculate the annual rate of psychiatric evacuation of U.S. Service members out of Iraq and Afghanistan and identify risk factors for evacuation.
  
  
  METHODS
  Descriptive and regression analyses were performed using deployment records for Service members evacuated from January 2004 through September 2010 with a psychiatric diagnosis, and a 20% random sample of all other deployers (N = 364,047).
  
  
  RESULTS
  A total of 5,887 deployers psychiatrically evacuated, 3,951 (67%) of which evacuated on first deployment. The rate increased from 72.9 per 100,000 in 2004 to 196.9 per 100,000 in 2010. Evacuees were overrepresented in both combat and supporting duty assignments. In multivariate analysis, Army active duty had the highest odds of evacuation relative to Army National Guard (adjusted odds ratio [AOR] 0.852, 95% confidence interval [CI] 0.790-0.919), Army Reserve (AOR 0.825, 95% CI 0.740-0.919), and all other components. Accessions in 2005 had the highest risk (AOR 1.923, 95% CI 1.621-2.006) relative to pre-2001 accessions.
  
  
  CONCLUSIONS
  Risk for psychiatric evacuation is highest among the Army Active Component. A strong link between multiple deployments or combat-related exposure and psychiatric evacuation is not apparent. Increased risk among post-2001 accessions suggests further review of changes in recruitment, training, and deployment policies and practices.
authors.affiliation: Byridine F. Lewis School of Nursing and Health Professions, Georgia State University, Atlanta, GA.
authors.forename: Margaret C
authors.initials: MC
authors.lastname: Wilmoth
authors.affiliation: Axiom Resource Management Inc., 2941 Fairview Park DDrive, Suite 900, Falls Church, VA 22042.
authors.forename: Andrea
authors.initials: A
authors.lastname: Linton
authors.affiliation: Axiom Resource Management Inc., 2941 Fairview Park DDrive, Suite 900, Falls Church, VA 22042.
authors.forename: Richard
authors.initials: R
authors.lastname: Gromadzki
authors.affiliation: Heller School for Social Policy and Management, Brandeis University, 415 South Street, MS 035, Waltham, MA 02454-9110.
authors.forename: Mary J
authors.initials: MJ
authors.lastname: Larson
authors.affiliation: Defense Health Costing Analyses and Program Evaluation, Defense Health Agency.
authors.forename: Thomas V
authors.initials: TV
authors.lastname: Williams
authors.affiliation: Assistant Secretary of Defense for Health Affairs, Department of Defense, 7700 Arlington Boulevard, Suite 5101, Falls Church, VA 22042-5101.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Woodson
mesh_terms: D000293:Adolescent; D000328:Adult; D055826:Afghan Campaign 2001-; D000367:Age Factors; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology* / Q000706:statistics & numerical data; D044469:Racial Groups / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014187:Transportation of Patients / Q000706:statistics & numerical data / Q000639:trends*; D014481:United States / Q000453:epidemiology; D055815:Young Adult