title: Missed opportunity to screen and diagnose PTSD and depression among deploying shipboard US military personnel.
abstract: BACKGROUND
  Depression and post-traumatic stress disorder (PTSD) are significant risks for suicide and other adverse events among US military personnel, but prevalence data among ship-assigned personnel at the onset of deployment are unknown.
  
  
  OBJECTIVE
  To determine the prevalence of shipboard personnel who screen positive for PTSD and/or major depressive disorder (MDD) at the onset of deployment, and also those who reported these diagnoses made by a physician or healthcare professional in the year prior to deployment.
  
  
  METHODS
  Active-duty ship-assigned personnel (N= 2078) completed anonymous assessments at the beginning of deployment. Depression was measured using the Center for Epidemiologic Studies Depression Scale (CES-D; score of ≥22), and PTSD was assessed using the PTSD Checklist-Civilian Version (PCL-C; both score and symptom criteria were used).
  
  
  RESULTS
  In total, 7.3% (n= 151 of 2076) screened positive for PTSD and 22% (n= 461 of 2078) for MDD at deployment onset. Only 6% and 15% of those who screened positive for PTSD or MDD, respectively, had been diagnosed by a healthcare professional in the past year.
  
  
  CONCLUSIONS
  Missed opportunities for mental healthcare among screen-positive shipboard personnel reduce the benefits associated with early identification and linkage to care. Improved methods of mental health screening that promote early recognition and referral to care may mitigate psychiatric events in theatre.
  
  
  BACKGROUND
  This work was performed as part of the official duties of the authors as military service members or employees of the US Government.
  This work was prepared by military service members or employees of the US Government as part of their official duties. As such, copyright protection is not available for this work (Title 17, USC, §105).
authors.affiliation: , PhD, US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA; Department of Defense HIV/AIDS Prevention Program (DHAPP), Naval Health Research Center, San Diego, CA, USA.
authors.forename: Judith
authors.initials: J
authors.lastname: Harbertson
authors.affiliation: , MD, MPH, Department of Defense HIV/AIDS Prevention Program (DHAPP), Naval Health Research Center, San Diego, CA, USA; University of California, San Diego, La Jolla, CA, USA.
authors.forename: Braden R
authors.initials: BR
authors.lastname: Hale
authors.affiliation: , MD, PhD, US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
authors.forename: Nelson L
authors.initials: NL
authors.lastname: Michael
authors.affiliation: , MD, MPH, US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
authors.forename: Paul T
authors.initials: PT
authors.lastname: Scott