Repeat deployments may take a toll on troops' health

Last Updated: 2010-01-15 13:00:43 -0400 (Reuters Health)

NEW YORK (Reuters Health) - National Guard troops who are sent to Iraq or Afghanistan more than once seem to have a heightened risk of mental and physical health problems.

Researchers found that among New Jersey National Guard troops readying for deployment to Iraq, those who had already served there or in Afghanistan were nearly four times as likely to screen positive for post-traumatic stress disorder (PTSD) as their counterparts who were deploying for the first time.

Similarly, they were three times more likely to have major depression, and twice as likely to have chronic pain or poorer-than-average physical functioning.

The findings, the researchers report in the American Journal of Public Health, call into question the "military readiness" of some the National Guard troops being sent to Iraq and Afghanistan.

They also suggest that the routine health screenings given before and after deployment are missing many cases of mental and physical health problems, say the investigators, led by Dr. Anna Kline of the Department of Veterans Affairs, New Jersey Health Care System in Lyons.

Using anonymous survey instruments, the researchers found that, for example, nearly 7 percent of all 2,543 troops in their study screened positive for PTSD. But the standard military assessments done before the troops' deployment suggested that less than 2 percent had PTSD.

Moreover, the surveys found that PTSD -- along with depression and physical health issues -- was even more common among troops who had been deployed previously.

Overall, Kline's team found, one-quarter of the troops they surveyed had previously been deployed, mainly to Iraq. Of these soldiers, 14 percent screened positive for PTSD symptoms, versus 4 percent of troops who had not been deployed before. Meanwhile, 5 percent had major depression, compared with 2 percent of their counterparts.

When it came to physical health, previously deployed troops were more likely to report problems like back and joint pain. Forty-two percent complained of chronic pain -- pain lasting at least six months -- versus 23 percent of soldiers who had not been deployed before.

In addition, previously deployed troops were twice as likely to have lower-than-average scores on a standard measure of physical functioning -- including a person's ability to climb stairs, kneel and bend down, and walk more than a mile. One-quarter of previously deployed soldiers scored below the norm for Americans their age and sex.

The findings suggest that, despite routine military health screenings, repeated deployments of National Guard troops to Iraq and Afghanistan "may result in a substantial number of medically impaired soldiers being returned to combat," Kline and her colleagues write.

And that, the researchers add, raises questions about the effectiveness of standard screening.

One problem may be that troops are reluctant to report mental and physical health symptoms, according to Kline's team. Of the previously deployed soldiers with PTSD symptoms in this study, many said they were concerned about "mental health stigma," the researchers note. And a majority -- 59 percent -- said they did not report their symptoms after deployment in order to avoid being placed on "medical hold."

The implication, according to the researchers, is that the military needs to develop better ways for troops to get "truly confidential and accessible" assessment and treatment of their physical and mental symptoms.

They add that the findings also suggest "the need to examine existing policies regarding multiple deployments of troops" to Iraq and Afghanistan.

SOURCE: American Journal of Public Health, online December 17, 2009.