title: Poorer Physical Health is Associated With Greater Mental Health Service Utilization in a Sample of Depressed U.S. Army National Guard Soldiers.
abstract: Operation Iraqi Freedom/Operation Enduring Freedom service members returning from deployment suffer from high rates of depression and report low levels of physical functioning compared to age-adjusted norms. Treatment for depression may be limited in this group and there are few data on whether Veterans receive medication treatment versus psychotherapy. We assessed rates of depression, physical functioning, and treatment with either medication or psychotherapy among recently returning service members.
  
  
  
  Study participants were recruited from National Guard soldiers in a Midwestern state (n = 1,448). Logistic regression modeling was used to examine associations between physical health and odds of receiving different types of mental health treatment for depressed individuals (n = 299).
  
  
  
  21% of soldiers reported significant depression and 44% of depressed service members reported poor physical health. Poorer physical health was associated with increased odds of any treatment (odds ratio: 1.27, confidence interval: 1.1-1.45) and medication treatment (odds ratio: 1.23, confidence interval: 1.08-1.40) but physical health was not associated with individual psychotherapy.
  
  
  
  Poor physical health is associated with increased likelihood of pharmacological but not individual psychotherapeutic treatment. Physical health problems may increase the need for depression care or increase contact with the medical system leading to higher levels of pharmacological treatment. Access to psychotherapy may need to be increased for Veterans with poor physical health.
authors.affiliation: VA Serious Mental Illness Treatment Resource and Evaluation Center, 2800 Plymouth Road, Ann Arbor, MI 48109.
authors.forename: Debra S
authors.initials: DS
authors.lastname: Levine
authors.affiliation: VA Serious Mental Illness Treatment Resource and Evaluation Center, 2800 Plymouth Road, Ann Arbor, MI 48109.
authors.forename: Rebecca K
authors.initials: RK
authors.lastname: Sripada
authors.affiliation: VA Serious Mental Illness Treatment Resource and Evaluation Center, 2800 Plymouth Road, Ann Arbor, MI 48109.
authors.forename: Dara
authors.initials: D
authors.lastname: Ganoczy
authors.affiliation: VA Serious Mental Illness Treatment Resource and Evaluation Center, 2800 Plymouth Road, Ann Arbor, MI 48109.
authors.forename: Heather
authors.initials: H
authors.lastname: Walters
authors.affiliation: Michigan Public Health Institute, 2436 Woodlake Drive, Okemos, MI 48864.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Gorman
authors.affiliation: VA Serious Mental Illness Treatment Resource and Evaluation Center, 2800 Plymouth Road, Ann Arbor, MI 48109.
authors.forename: Marcia
authors.initials: M
authors.lastname: Valenstein
mesh_terms: D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D003863:Depression / Q000523:psychology / Q000628:therapy*; D005260:Female; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D015146:Midwestern United States; D008889:Military Personnel / Q000523:psychology*; D016017:Odds Ratio; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires