The prevalence of mental health disorders in (ex-)military personnel with a physical impairment: a systematic review

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. Method 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.

[1]  et.al. Sabah Mohammed Daylami.  Seasonality Effects on Amman Stock Exchange: Return and Volatility Applied Study on Sectoral Indices , 2013 .

[2]  M. Galarneau,et al.  Short-Term Physical and Mental Health Outcomes for Combat Amputee and Nonamputee Extremity Injury Patients , 2013, Journal of orthopaedic trauma.

[3]  Ryan E. Moore,et al.  Health-related quality-of-life status in Veterans with spinal disorders , 2013, Quality of Life Research.

[4]  Roman A Hayda,et al.  The Military Extremity Trauma Amputation/Limb Salvage (METALS) study: outcomes of amputation versus limb salvage following major lower-extremity trauma. , 2013, The Journal of bone and joint surgery. American volume.

[5]  G. Reiber,et al.  Combat-incurred bilateral transfemoral limb loss: A comparison of the Vietnam War to the wars in Afghanistan and Iraq , 2012, The journal of trauma and acute care surgery.

[6]  J. Breeze.  Saving Faces: The UK Future Facial Protection Programme , 2012, Journal of the Royal Army Medical Corps.

[7]  H. Forbes,et al.  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 , 2012, BMC Psychiatry.

[8]  S. Durning,et al.  The association between specialty match and third-year clerkship performance. , 2012, Military medicine.

[9]  Matthew K Nock,et al.  Prevalence of DSM-IV major depression among U.S. military personnel: meta-analysis and simulation. , 2012, Military medicine.

[10]  J. Bandara,et al.  The prevalence of symptoms of Post-Traumatic Stress Disorder among soldiers with amputation of a limb or spinal injury: A report from a rehabilitation centre in Sri Lanka , 2012, Psychology, health & medicine.

[11]  Andrew A. Rooney,et al.  Forest Plot Viewer: a new graphing tool. , 2011, Epidemiology.

[12]  M. Galarneau,et al.  Visual dysfunction following blast-related traumatic brain injury from the battlefield , 2011, Brain injury.

[13]  Christopher Dandeker,et al.  What are the consequences of deployment to Iraq and Afghanistan on the mental health of the UK armed forces? A cohort study , 2010, The Lancet.

[14]  M. Hotopf,et al.  Mental health and health service use among post-national service veterans: results from the 2007 Adult Psychiatric Morbidity Survey of England , 2010, Psychological Medicine.

[15]  C. Hoge,et al.  Relationship of combat experiences to alcohol misuse among U.S. soldiers returning from the Iraq war. , 2010, Drug and alcohol dependence.

[16]  M. Galarneau,et al.  Midterm health and personnel outcomes of recent combat amputees. , 2010, Military medicine.

[17]  R. Acierno,et al.  Prevalence Estimates of Combat-Related Post-Traumatic Stress Disorder: Critical Review , 2010, The Australian and New Zealand journal of psychiatry.

[18]  B. Golomb,et al.  Psychological correlates of battle and nonbattle injury among Operation Iraqi Freedom veterans. , 2009, Military medicine.

[19]  M. Ebrahimzadeh,et al.  Long-term clinical outcomes of Iranian veterans with unilateral transfemoral amputation , 2009, Disability and rehabilitation.

[20]  John B Holcomb,et al.  Amputations in U.S. Military Personnel in the Current Conflicts in Afghanistan and Iraq , 2008, Journal of orthopaedic trauma.

[21]  M. Fagelson.  The association between tinnitus and posttraumatic stress disorder. , 2007, American journal of audiology.

[22]  R. Bellamy.  A note on American combat mortality in Iraq. , 2007, Military medicine.

[23]  Charles E. Wade,et al.  Causes of Death in U.S. Special Operations Forces in the Global War on Terrorism: 2001–2004 , 2007, Annals of surgery.

[24]  John F Kragh,et al.  Characterization of Extremity Wounds in Operation Iraqi Freedom and Operation Enduring Freedom , 2007, Journal of orthopaedic trauma.

[25]  Charles Marmar,et al.  Bringing the war back home: mental health disorders among 103,788 US veterans returning from Iraq and Afghanistan seen at Department of Veterans Affairs facilities. , 2007, Archives of internal medicine.

[26]  N. Gunawardena,et al.  Mental Health Outcome Of Unilateral Lower Limb Amputee Soldiers In Two Districts Of Sri Lanka , 2007, The International journal of social psychiatry.

[27]  Besa Smith,et al.  Millennium Cohort: the 2001-2003 baseline prevalence of mental disorders in the U.S. military. , 2007, Journal of clinical epidemiology.

[28]  Soo-Jung Lee,et al.  Interrelationships among pain, disability, and psychological factors in young Korean conscripts with lumbar disc herniation. , 2006, Military medicine.

[29]  P. Kaboli,et al.  THE RELATIONSHIP BETWEEN HEARING IMPAIRMENT AND DEPRESSION IN OLDER VETERANS , 2006, Journal of the American Geriatrics Society.

[30]  Christopher Dandeker,et al.  The health of UK military personnel who deployed to the 2003 Iraq war: a cohort study , 2006, The Lancet.

[31]  Malcolm MacLachlan,et al.  Affective distress and amputation-related pain among older men with long-term, traumatic limb amputations. , 2006, Journal of pain and symptom management.

[32]  Charles W Hoge,et al.  Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan. , 2006, JAMA.

[33]  S. Flaherty,et al.  Trauma system development in a theater of war: Experiences from Operation Iraqi Freedom and Operation Enduring Freedom. , 2005, The Journal of trauma.

[34]  A. Cohen,et al.  Increased PTSD risk with combat-related injury: a matched comparison study of injured and uninjured soldiers experiencing the same combat events. , 2005, The American journal of psychiatry.

[35]  P. Jayawardana,et al.  Psychological Status and Physical Disabilities of Permanently Disabled Sri Lankan Servicemen , 2004 .

[36]  O. Horgan,et al.  Psychosocial adjustment to lower-limb amputation: A review , 2004, Disability and rehabilitation.

[37]  C. Hoge,et al.  Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. , 2004, The New England journal of medicine.

[38]  C. Blood,et al.  An assessment of the potential for reducing future combat deaths through medical technologies and training. , 2002, The Journal of trauma.

[39]  O. Ajetunmobi.  Making Sense of Critical Appraisal , 2002 .

[40]  E. Martz,et al.  Physical Impairments as Risk Factors for the Development of Posttraumatic Stress Disorder , 2001 .

[41]  M. Binks,et al.  A comparison of posttraumatic stress disorder in veterans with and without spinal cord injury. , 1998, Journal of abnormal psychology.

[42]  M. Binks,et al.  Posttraumatic Stress Disorder in Veterans with Spinal Cord Injury: Trauma-related Risk Factors , 1998, Journal of traumatic stress.

[43]  T. Sivik,et al.  The effect of different traumatic experiences on the development of post-traumatic stress disorder. , 1995, Military medicine.

[44]  G. Reiber,et al.  Major traumatic limb loss among women veterans and servicemembers. , 2013, Journal of rehabilitation research and development.

[45]  M. Wade.  Brain injury and stress disorder strong indicators of vision problems for veterans. , 2013, Insight.

[46]  Charles Maynard,et al.  Servicemembers and veterans with major traumatic limb loss from Vietnam war and OIF/OEF conflicts: survey methods, participants, and summary findings. , 2010, Journal of rehabilitation research and development.

[47]  Allen W Heinemann,et al.  Quality of life for veterans and servicemembers with major traumatic limb loss from Vietnam and OIF/OEF conflicts. , 2010, Journal of rehabilitation research and development.

[48]  D. Desmond,et al.  Coping, affective distress, and psychosocial adjustment among people with traumatic upper limb amputations. , 2007, Journal of psychosomatic research.

[49]  Lisa Pearse,et al.  Causes of death in US Special Operations Forces in the global war on terrorism: 2001-2004. , 2007, U.S. Army Medical Department journal.

[50]  T. Sivik,et al.  Certain psychological characteristics of soldiers injured in the 1991–1993 war in Croatia , 2000 .

[51]  T. Sivik,et al.  Post‐traumatic stress disorder among Croat soldiers in the defence war in Croatia 1991–1993 , 1998 .

[52]  D. Summerfield,et al.  After the war in Nicaragua: a psychosocial study of war wounded ex-combatants. , 1994, Medicine and war.