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A new study shows that 106,726 Iraq and Afghanistan war veterans within the Veterans Affairs Department health care system have been diagnosed with mental health issues.
That's 37 percent of the 289,328 veterans who have sought care. Of those, 62,979 — or 22 percent — have been diagnosed with post-traumatic stress disorder.
About 1.6 million troops have served in Iraq and Afghanistan.
The study notes that those numbers are far higher than a military study showing that only 12 percent of active-duty combat veterans received mental health diagnoses from the Military Health System.
That may be because PTSD can show up years after a person experiences a traumatic event.
Another possible reason, lead author Karen Seal wrote, is that "veterans seeking VA care may have less stigma- and career-related concerns than do active-duty military personnel about disclosing mental health problems, and VA clinicians may be more apt to record mental health diagnoses in the clinical record than are military health providers."
Seal is a researcher at the San Francisco VA Medical Center.
The study, published in the September issue of the American Journal of Public Health, sought to find out whether those diagnoses have increased as the wars continued.
Clearly, they have. From the beginning of the study in April 2002 to the end in March 2008, mental health diagnoses increased from 6 percent to 37 percent. About 29 percent of those veterans had two mental health diagnoses, while one-third had three or more diagnoses.
Seal gave a few reasons for why veterans may have higher rates of depression and social disorders than they did early in the wars: Public support for the wars has waned; there is no front line in Iraq, so there are unexpected threats, such as roadside bombs; and many veterans have served multiple tours.
The researchers looked at all diagnoses that have been associated with trauma, such as PTSD, depressive disorders, alcohol use disorder and drug use disorders, as well as psychosocial and behavioral problems such marital or family problems.
They found that National Guard and reserve veterans tended to be older: More than half were over 30, while two-thirds of active duty veterans were under 30.
While the reservists had higher rates of all mental health issues, especially PTSD and depression, the active-duty troops were more likely to resort to alcohol and drug abuse. Seal said those rates are probably low due to underreporting — because of shame or because a veteran's drug abuse may be illegal.
Researchers also found that veterans under age 25 had twice the rate of PTSD as well as substance-abuse disorders compared to active-duty troops older than 40. Seal said younger vets are more likely to have seen combat because of their lower ranks.
Reservists may have higher rates of mental health issues because they "are more likely established in civilian occupations; have family, social and community ties; and have had less preparation for combat, making their transition from the war zone and then home again more stressful," Seal wrote.
Women were more likely to be diagnosed with depression than men, but were less likely to abuse drugs or alcohol.
The authors recommended targeted screening and early intervention to prevent chronic mental health problems.