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Preinjury Psychiatric Status, Injury Severity, and Postdeployment Posttraumatic Stress Disorder

Donald A. Sandweiss, MD, MPH; Donald J. Slymen, PhD; Cynthia A. LeardMann, MPH; Besa Smith, PhD, MPH; Martin R. White, MPH; Edward J. Boyko, MD, MPH; Tomoko I. Hooper, MD, MPH; Gary D. Gackstetter, DVM, PhD, MPH; Paul J. Amoroso, MD, MPH; Tyler C. Smith, MS, PhD; for the Millennium Cohort Study Team;Arch Gen Psychiatry. 2011;68(5):496-504. doi:10.1001/archgenpsychiatry.2011.44

Of 22 630 eligible participants, 1840 (8.1%) screened positive for PTSD at follow-up, and 183 (0.8%) sustained a deployment-related physical injury that was documented in the Joint Theater Trauma Registry or the Navy–Marine Corps Combat Trauma Registry Expeditionary Medical Encounter Database. The odds of screening positive for PTSD symptoms were 2.52 (95% confidence interval, 2.01-3.16) times greater in those with 1 or more defined baseline mental health disorder and 16.1% (odds ratio, 1.16; 95% confidence interval, 1.01-1.34) greater for every 3-unit increase in the Injury Severity Score. Irrespective of injury severity, self-reported preinjury psychiatric status was significantly associated with PTSD at follow-up.

Baseline psychiatric status and deployment-related physical injuries were associated with screening positive for postdeployment PTSD. More vulnerable members of the deployed population might be identified and benefit from interventions targeted to prevent or to ensure early identification and treatment of postdeployment PTSD.

Read the abstract at www.archpsyc.ama-assn.org.