New Onset and Persistent Symptoms of Posttraumatic Stress Disorder Self Reported after Deployment and Combat Exposures: Prospective Population Based US Military Cohort Study

摘要

Objective: To describe new onset and persistence of PTSD symptoms in a large population-based military cohort, many of whom deployed in support of the Global War on Terrorism (GWOT). Design, Setting, and Participants: Millennium Cohort Study baseline enrollment data (July 2001 to June 2003) were obtained before the current GWOT. Follow-up (June 2004 to January 2006) data on health outcomes were collected from over 50 000 participants. Main Outcome Measures: PTSD as measured by the PTSD Checklist-Civilian version (PCL-C) with the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) criteria. Results: Over 40% of the Cohort was deployed between 2001 and 2006, with 24% deployed for the first time in support of the GWOT between baseline and follow-up questionnaire submission. New-onset PTSD symptoms or diagnosis was identified in 7.6% to 8.7% of deployers reporting combat exposures, 1.4% to 2.1% of deployers not reporting combat exposures, and 2.3% to 3.0% of nondeployers. Among those with baseline PTSD symptoms, persistent symptoms were found in 47.9% of deployers reporting combat exposures and 45.9% of nondeployers. Temporal assessment of new-onset PTSD symptoms after deployment with combat exposures suggests a bimodal distribution of when symptoms may be most prevalent. Conclusions: After adjusting for baseline characteristics, these prospective data indicate a threefold increase in new-onset PTSD symptoms or diagnosis among deployed military personnel reporting combat exposures. Findings define the importance of PTSD in this population and emphasize that specific combat exposures, rather than deployment itself, significantly affect the onset of PTSD symptoms postdeployment.