The stress and depression caused by combat in Iraq often don't appear until a few months after a soldier has returned home, researchers reported today.
Six months after their deployment ended, the number of soldiers referred for mental health care was nearly three times as high as when they first returned, and the number reporting relationship problems with their families and others had quadrupled, according to results from a new screening tool used by the military to assess the troops' mental health.
Overall, about 20% of active-duty Army soldiers and more than 40% of National Guardsmen and reservists were referred for care or had sought care on their own, a military team reported in the Journal of the American Medical Assn.
Psychologists hope that catching problems early and getting soldiers into treatment will prevent the type of long-term mental health problems that afflicted many soldiers who fought in Vietnam, said Dr. Charles S. Milliken of the Walter Reed Army Institute of Research, who led the study.
"We know from civilian studies and others . . . that if you can get to these problems earlier, the chances of effectively treating them are much better," he said.
The incidence of mental health problems during the Vietnam War was about the same as that of the current war, he noted. But studies have shown that as many as 10% of Vietnam vets still suffer chronic and disabling symptoms.
The trends reported by Milliken and his colleagues are similar to those seen in smaller studies of returning Iraqi veterans, but some experts cautioned that the absolute numbers of troubled soldiers may be artificially high because of the nature of the questionnaires used.
Psychologist Richard J. McNally of Harvard University noted that he and Dutch colleagues published a study on Dutch soldiers earlier this year using a similar questionnaire. The questionnaire showed that about 20% of the professional soldiers suffered symptoms of depression and post-traumatic stress disorder (PTSD).
But when the subjects underwent clinical interviews, they found, only about 4% actually suffered the disorders.
Milliken conceded that the large numbers did not represent clinical diagnoses.
"We have intentionally set the bar pretty low," he said. "We're hoping to find early symptoms and intervene before they can become full-fledged clinical diagnoses."
