摘要：Objectives. We examined (1) mental and physical health symptoms and functioning in US veterans within 1 year of returning from deployment, and (2) differences by gender, service component (Active, National Guard, other Reserve), service branch (Army, Navy, Air Force, Marines), and deployment operation (Operation Enduring Freedom/Operation Iraqi Freedom [OEF/OIF]). Methods. We surveyed a national sample of 596 OEF/OIF veterans, oversampling women to make up 50% of the total, and National Guard and Reserve components to each make up 25%. Weights were applied to account for stratification and nonresponse bias. Results. Mental health functioning was significantly worse compared with the general population; 13.9% screened positive for probable posttraumatic stress disorder, 39% for probable alcohol abuse, and 3% for probable drug abuse. Men reported more alcohol and drug use than did women, but there were no gender differences in posttraumatic stress disorder or other mental health domains. OIF veterans reported more depression or functioning problems and alcohol and drug use than did OEF veterans. Army and Marine veterans reported worse mental and physical health than did Air Force or Navy veterans. Conclusions. Continuing identification of veterans at risk for mental health and substance use problems is important for evidence-based interventions intended to increase resilience and enhance treatment. The mental and physical health of veterans returning from war zone deployment is of substantial concern to the public as well as military leaders and civilian policymakers. 1 Although most veterans return from deployment without suffering long-term consequences, a significant number experience serious psychological harm. Recent research on the Gulf War and Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans confirmed increased risk for mental health problems, including posttraumatic stress disorder (PTSD), depression, suicidality, neuropsychological deficits, and alcohol and drug use. 2–7 These disorders have implications for individual and unit readiness; physical, social, and emotional health of veterans and their families; and the Veterans Health Administration and other health care systems in which veterans obtain services. 4,7,8 Mental health problems are also often compounded by problems with physical health. 9 Recent conflicts resulted in over 46 000 soldiers wounded in action, some with serious and debilitating conditions, such as chronic pain, traumatic brain injury, and high risk for cardiovascular disease. 10–13 The objectives of our study were to examine (1) mental and physical health symptoms and functioning, including posttraumatic stress symptoms (PTSS), and alcohol and drug use in a national sample of veterans within 1 year of returning from deployment in Afghanistan or Iraq; and (2) differences in mental and physical health and alcohol and drug use by gender, service component (Active, National Guard, other Reserve), service branch (Army, Navy, Air Force, Marines), and deployment operation (OIF or OEF). Examination of differences in mental health, alcohol use, and drug use is important for identifying those at high risk so that evidence-based interventions to prevent and treat serious disorders can be implemented when indicated. Gender, service component, branch, and deployment operation are of interest because previous research identified differences in mental health, alcohol use, and drug use as a function of these factors. Continued assessment of these issues is valuable, because as the focus and scope of military engagement changes over time, the sequelae of deployment may also change, resulting in different subgroups emerging as high risk. Previous research suggested that women were at higher risk for mental health conditions including depression, anxiety, and PTSD after traumatic exposure, whereas men were at higher risk for substance use disorders. 14–19 Based on these findings, we hypothesized that women would report more symptoms of depression and PTSD but less alcohol and drug use than men. Previous research found National Guard and Reservists to be at higher risk for mental health, alcohol use, and drug use disorders than Active component personnel. 20–23 Consequently, we hypothesized more mental health, alcohol use, and drug use problems among National Guard and Reservists than among Active component members. Several studies identified Army or Marine veterans as at higher risk for PTSD, depression, or alcohol misuse compared with Navy or Air Force veterans. 16,22,24–27 Based on these findings, we hypothesized higher levels of PTSD, other mental health symptoms, alcohol use, and drug use among Army and Marines compared with Navy and Air Force veterans. Significantly more mental health symptoms were reported among OIF (Iraq) veterans compared with OEF (Afghanistan) veterans, 2,4,11,28 leading us to hypothesize more mental health symptoms and greater substance use among OIF than OEF veterans.
