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Mental health outcomes of male UK military personnel deployed to Afghanistan and the role of combat-injury: The ADVANCE cohort study

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Title: Mental health outcomes of male UK military personnel deployed to Afghanistan and the role of combat-injury: The ADVANCE cohort study
Authors: Dyball, D
Bennett, A
Schofield, S
Cullinan, P
Boos, C
Bull, A
Wessely, S
Stevelink, S
Fear, N
On behalf of the ADVANCE study
Item Type: Journal Article
Abstract: Background: The long-term psychosocial outcomes of UK Armed Forces personnel who sustained serious combat-injuries during deployment to Afghanistan are largely unknown. This study hypothesised that the rates of probable Post Traumatic Stress Disorder (PTSD), depression, anxiety and mental health multimorbidity will be greater among a representative sample of ex-/serving military personnel with combat injuries compared to a matched sample of uninjured ex-/serving military personnel. Methods: 579 combat-injured and a comparison group of 565 uninjured male UK Armed Forces ex-/serving personnel, frequency-matched by age, rank, regiment, deployment, and role on deployment were included in this analysis. Participants had a median age of 33 (IQR 30, 37) at time of assessment. 90·3% identified as white and 9·7% were from all other ethnic groups. Participants completed a comprehensive health assessment including both physical health assessment and self-reported mental health measures. Results: The rates of PTSD (16·9% vs 10·5%; Adjusted Odds Ratio (AOR) 1·67 (95% Confidence Interval (CI) 1·16, 2·41), depression (23·6% vs 16·8%; AOR 1·46 (95%CI 1·08, 2·03), anxiety (20·8% vs 13·5%; AOR 1·56 (95%CI 1·13, 2·24) and mental health multimorbidity (15·3% vs 9·8%; AOR 1·62 (95%CI 1·12, 2·49) were greater in the injured versus uninjured group respectively. Minimal differences in odds of reporting any poor mental health outcome were noted between the amputation injury subgroup and the uninjured group, whereas up to double the odds were noted for the non-amputation injury subgroup. Interpretation: Serious physical combat-injuries are associated with poor mental health outcomes. However, type of injury influences this relationship. Regardless of injury, this cohort represents a group who present with greater rates of PTSD compared to the general population and increased psychological burden from multimorbidity. Funding: The ADVANCE study receives funding through the ADVANCE study charity, the key contributors to which are the Headley Court Charity, HM Treasury (LIBOR Grant), Help for Heroes, Blesma-The Limbless Veterans Charity, Nuffield Trust for the Forces of the Crown, the Forces in Mind Trust and the UK Ministry of Defence.
Date of Acceptance: 24-Mar-2022
URI: http://hdl.handle.net/10044/1/96678
ISSN: 2215-0366
Publisher: Elsevier
Journal / Book Title: The Lancet Psychiatry
Sponsor/Funder: Ministry Of Defence
Defence Medical Rehabilitation Centre
Funder's Grant Number: nil
n/a
Keywords: 1103 Clinical Sciences
1117 Public Health and Health Services
1701 Psychology
Publication Status: Accepted
Embargo Date: Embargoed for 6 months after publication date
Appears in Collections:Bioengineering
National Heart and Lung Institute
Faculty of Medicine



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