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Studies

On this page you can find various studies developed by Military Health System. Please scroll down or use the search box to find specific studies.

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We found 213 items resulting from your search.

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Use and Abuse of Prescribed Opioids, Central Nervous System Depressants, and Stimulants Among U.S. Active Duty Military Personnel in FY 2010

Study

Abstract

OBJECTIVES: This study establishes rates of use/abuse of Schedule II-IV prescription medications in U.S. active duty military personnel, and characterizes correlates of such use/abuse. METHODS: All active duty personnel serving for 12 months during fiscal year 2010 were included. Data were obtained from medical and pharmacy claims and drug screening results. Logistic regression models were used to examine predictors of drug use, along with bivariate analyses to compare abuse of prescribed and illegal drugs. RESULTS: Nearly one-third of active duty service members received at least one prescription for opioids, central nervous system depressants, or stimulants, with 26.4% having received at least one prescription for opioids. About 0.7%, 1.4%, and 0.6% of the total force received >90-day prescriptions for opioids, central nervous system depressants, or stimulants, respectively. Battlefield injury, receipt of psychotropic medications, and substance abuse adverse events were predictive of >90-day supply of opioids. About 0.7% of the total force had documented known drug abuse for prescribed drugs compared to 0.4% for illegal drug abuse. CONCLUSIONS: We recommend systematic monitoring of prescriptions for controlled substances which may carry serious consequences, evaluation of the impact of controlled substances on military readiness, and examination of the rationale for prescribing controlled drugs.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Defense Health Agency (formerly TRICARE Management Activity)
  • Congressionally Mandated: No
  • Funding Source: Undetermined
  • Release Date/Publication: October 01, 2014
  • Citation: Jeffery DD, May L, Luckey B, Balison BM, Klette KL. Use and Abuse of Prescribed Opioids, Central Nervous System Depressants, and Stimulants Among U.S. Active Duty Military Personnel in FY 2010. Mil Med. 2014 Oct;179(10):1141-8

Female military medical school graduates entering surgical internships: are we keeping up with national trends?

Study

Abstract

BACKGROUND: Ratios of women graduating from the only US military medical school and entering surgical internships were reviewed and compared with national trends. METHODS: Data were obtained from the Uniformed Services University of the Health Sciences graduation announcements from 2002 to 2012. RESULTS: There were 1,771 graduates from 2002 to 2012, with 508 female (29%) and 1,263 male (71%) graduates. Female graduates increased over time (21% to 39%; P = .014). Female general surgery interns increased from 3.9% to 39% (P = .025). Female overall surgical subspecialty interns increased from 20% in 2002 to 36% in 2012 (P = .046). Women were represented well in obstetrics (57%), urology (44%), and otolaryngology (31%), but not in neurosurgery, orthopedics, and ophthalmology (0% to 20%). CONCLUSIONS: The sex disparity between military and civilian medical students occurs before entry. Once in medical school, women are just as likely to enter general surgery or surgical subspecialty as their male counterparts. Increased ratio of women in the class is unlikely to lead to a shortfall except in specific subspecialties.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Walter Reed National Military Medical Center/Uniformed Services University of Health Sciences
  • Congressionally Mandated: No
  • Funding Source: Defense Health Agency (formerly TRICARE Management Activity)
  • Release Date/Publication: October 01, 2014
  • Citation: Vertrees A, Laferriere N, Elster E, Shriver CD, Rich NM. Female military medical school graduates entering surgical internships: are we keeping up with national trends? Am J Surg. 2014 Oct;208(4):550-5.

Gender differences in the expression of PTSD symptoms among active duty military personnel.

Study

Abstract

This study examined gender differences in posttraumatic stress disorder (PTSD) symptoms and symptom factors in the total U.S. active duty force. Data were drawn from the 2008 Department of Defense Survey of Health Related Behaviors among Active Duty Military Personnel including 17,939 men and 6751 women from all services. The results indicated that women expressed more distress than men across almost all the symptoms on the PTSD Checklist except for hypervigilance. Women also scored significantly higher on all four factors examined: Re-experiencing, Avoidance, Emotionally Numb, Hyperarousal. More women than men were distressed by combat experiences that involved some type of violence, such as being wounded, witnessing or engaging in acts of cruelty, engaging in hand-to-hand combat, and, to a lesser extent, handling dead bodies. Men who had been sexually abused had a greater number of symptoms and were consistently more distressed than women on individual symptoms and symptom factors.

  • Publication Status: Published
  • Sponsoring Organization: Undetermined
  • Sponsoring Office:
  • Congressionally Mandated: No
  • Funding Source: Undetermined
  • Release Date/Publication: December 01, 2014
  • Citation: Hourani L, Williams J, Bray R, Kandel D. Gender differences in the expression of PTSD symptoms among active duty military personnel. J Anxiety Disord. 2014 Dec 5;29C:101-108.

Sexual Assault and Sexual Harassment in the U.S. Military Top-Line Estimates for Active-Duty Service Members from the 2014 RAND Military Workplace Study

Study

Abstract

In early 2014, the Department of Defense (DoD) Sexual Assault Prevention and Response Office (SAPRO) asked the RAND National Defense Research Institute (NDRI) to conduct an independent assessment of sexual assault, sexual harassment, and gender discrimination in the military — an assessment last conducted in 2012 by the department itself with the Workplace and Gender Relations Survey of Active Duty Personnel (WGRA). This report provides initial top-line estimates from the resulting study, the RAND Military Workplace Study (RMWS), which included a survey of 560,000 U.S. service members fielded in August and September of 2014. Compared to the prior DoD studies, the RMWS takes a new approach to counting individuals in the military who experienced sexual assault, sexual harassment, or gender discrimination. Our measurement of sexual assault aligns closely with the definitions and criteria in the Uniform Code of Military Justice (UCMJ) for Article 120 crimes. The survey measures of sexual harassment and gender discrimination, which together we refer to as sex-based military equal opportunity (MEO) violations, use criteria drawn directly from DoD Directive 1350.2. Compared with past surveys that were designed to measure a climate of sexual misconduct associated with illegal behavior, the approach used in the RMWS offers greater precision in estimating the number of crimes and MEO violations that have occurred. However, recognizing that DoD is also interested in trends in sexual assault, sexual harassment, and gender discrimination, RAND fielded a portion of the 2014 surveys using the same questions as previous DoD surveys on this topic. Key Findings RAND Researchers Estimate That, as of Early Fall of 2014, Approximately 20,000 of the U.S. Military's 1.3 Million Active-Duty Members Experienced One or More Sexual Assaults in the Past Year This figure includes assaults by other service members, civilians, spouses or others. It represents 4.9 percent of active-duty women and 1 percent of active-duty men. An Estimated 26 Percent of Active-Duty Women and 7 Percent of Active-Duty Men Experienced Sexual Harassment or Gender Discrimination in the Past Year Close to one third of women in the Navy and Marines experienced one of these violations in the past year. The majority of these violations involve experiences consistent with a sexually hostile work environment; however, significant numbers of women also indicate having experienced gender discrimination. We estimate that in the Army, almost 1 in 12 men experienced such a violation in the past year; in the Navy, it was nearly 1 in 10. For men, the largest source of problems stem from sexually hostile work environments, not gender discrimination or sexual quid pro quo. The Study Found Significant Differences in Rates of Sexual Assaults and Sex-Based MEO Violations by Branch of Service Fewer Air Force men and women experienced these events than their counterparts in the other services. In forthcoming reports, RAND will investigate if some of these service differences are attributable to differences in member demographics (e.g., age and education levels), cultures, or policies across services. Trend Data Suggest That Rates of Unwanted Sexual Contact and Sexual Harassment for Active-Duty Women Have Declined from 2012; Rates for Both Men and Women Are Lower Than in 2006, But About the Same as in 2010 We estimate that the percentage of active-duty women who experienced unwanted sexual contact as measured by the WGRA methods declined from 6.1 percent in 2012 to 4.3 percent in 2014; the same percentages for men did not see a statistically significant change (1.2 percent in 2012 compared with 0.9 percent in 2014). Similarly, estimates for the percentage of women who experienced sexual harassment in the past year declined significantly from 23.2 percent in 2012 to 20.2 percent in 2014; for men, the percentage in 2014 (3.5 percent) was not significantly lower than in 2012 (4.1 percen

  • Publication Status: Published
  • Sponsoring Organization: DoD agency, office, or organization other than the Army, Navy, Air Force, or Defense Health Agency
  • Sponsoring Office: National Development and Research Institutes, Inc.
  • Congressionally Mandated: No
  • Funding Source: Federally Funded Research and Development Center
  • Release Date/Publication: December 01, 2014
  • Citation: Rand Corporation, National Defense Research Institute

Stress in Service Members.

Study

Abstract

Military service differs from civilian jobs in the stressors that service members experience, including frequent deployments (eg, to an area of combat operations), obedience, regimentation, subordination of self to the group, integrity, and flexibility. The military culture emphasizes teamwork and peer support. In some cases, service members cannot adapt to military life, become overwhelmed by stress, or cannot overcome a traumatic experience. Clinicians should conduct a thorough evaluation guided by an understanding of the military culture. Every effort should be made to identify the stress and the maladaptive response and provide early clinical interventions to prevent progression.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Walter Reed National Military Medical Center
  • Congressionally Mandated: No
  • Funding Source: Defense Health Agency (formerly TRICARE Management Activity)
  • Release Date/Publication: December 01, 2014
  • Citation: Lande RG. Stress in Service Members. Psychiatr Clin North Am. 2014 Dec;37(4):547-560. doi: 10.1016/j.psc.2014.08.007.

Sexual Assault and Sexual Harassment in the U.S. Military Top-Line Estimates for Active-Duty Coast Guard Members from the 2014 RAND Military Workplace Study

Study

Abstract

In early 2014, the Department of Defense (DoD) Sexual Assault Prevention and Response Office (SAPRO) asked the RAND National Defense Research Institute (NDRI) to conduct an independent assessment of sexual assault, sexual harassment, and gender discrimination in the military — an assessment last conducted in 2012 by the department itself with the Workplace and Gender Relations Survey of Active Duty Personnel (WGRA). Separately, the Coast Guard requested that we expand the 2014 study to include an assessment of its active and reserve force. This report provides initial top-line active-duty Coast Guard estimates from the resulting RAND Military Workplace Study, which invited close to 560,000 service members to participate in a survey fielded in August and September of 2014. The RMWS takes an approach to counting individuals in the military who experienced sexual assault, sexual harassment, or gender discrimination that measures the incidence of specific crimes and violations. Our measurement of sexual assault aligns closely with the definitions and criteria in the Uniform Code of Military Justice (UCMJ) for Article 120 crimes. The survey measures of sexual harassment and gender discrimination, which together we refer to as sex-based military equal opportunity (MEO) violations, use criteria drawn from DoD Directive 1350.2. Compared with past surveys that were designed to measure a climate of sexual misconduct associated with illegal behavior, the approach used in the RMWS offers greater precision in estimating the number of crimes and MEO violations that have occurred. Key Findings RAND Researchers Estimate That, as of Early Fall of 2014, Approximately 270 of the U.S. Coast Guard's 39,000 Active-Duty Members Experienced One or More Sexual Assaults in the Past Year This figure includes assaults by other service members, civilians, spouses or others. It represents 3.0 percent of active-duty women and 0.3 percent of active-duty men. Nearly a Quarter of Active-Duty Women Experienced Sexual Harassment or Gender Discrimination in the Past Year The majority of these sex-based military equal opportunity (MEO) violations involve experiences consistent with a sexually hostile work environment or gender discrimination. Our estimate of the prevalence of sex-based MEO violations against active-duty Coast Guard men is substantially lower, though still affecting about 1 in 22 men. These violations usually involve hostile work environments. The Study Found That A Smaller Proportion of Coast Guard Members Experienced Sexual Assaults Than Found Among Their Counterparts in the Other U.S. Military Services In forthcoming reports, RAND will investigate if some of these service differences are attributable to differences in member demographics (e.g., age and education levels), cultures, or policies across services. Men in the Coast Guard experienced lower rates of sex-based MEO violations than men in the other services.

  • Publication Status: Published
  • Sponsoring Organization: DoD agency, office, or organization other than the Army, Navy, Air Force, or Defense Health Agency
  • Sponsoring Office: National Development and Research Institutes, Inc.
  • Congressionally Mandated: No
  • Funding Source: Federally Funded Research and Development Center
  • Release Date/Publication: December 01, 2014
  • Citation: Rand Corporation, National Defense Research Institute

Chronic multisymptom illness: a comparison of iraq and afghanistan deployers with veterans of the 1991 gulf war.

Study

Abstract

Symptoms and illnesses reported by veterans of the 1991 Gulf War era are a cause of potential concern for those military members who have deployed to the Gulf region in support of more recent contingency operations in Iraq and Afghanistan. In the present study, we quantified self-reported symptoms from participants in the Millennium Cohort Study, a prospective study representing all US service branches, including both active duty and Reserve/National Guard components (2001-2008). Self-reported symptoms were uniquely compared with those in a cohort of subjects from the 1991 Gulf War to gain context for the present report. Symptoms were then aggregated to identify cases of chronic multisymptom illness (CMI) based on the case definition from the Centers for Disease Control and Prevention. The prevalence of self-reported CMI symptoms was compared with that collected in 1997-1999 from a study population of US Seabees from the 1991 Gulf War, as well as from deployed and nondeployed subgroups. Although overall symptom reporting was much less in the Millennium Cohort than in the 1991 Gulf War cohort, a higher prevalence of reported CMI was noted among deployed compared with nondeployed contemporary cohort members. An increased understanding of coping skills and resilience and development of well-designed screening instruments, along with appropriate clinical and psychological follow-up for returning veterans, might help to focus resources on early identification of potential long-term chronic disease manifestations.

  • Publication Status: Published
  • Sponsoring Organization: Undetermined
  • Sponsoring Office:
  • Congressionally Mandated: No
  • Funding Source: Undetermined
  • Release Date/Publication: December 01, 2014
  • Citation: Smith TC, Powell TM, Jacobson IG, Smith B, Hooper TI, Boyko EJ, Gackstetter GD. Chronic multisymptom illness: a comparison of iraq and afghanistan deployers with veterans of the 1991 gulf war. Am J Epidemiol. 2014 Dec 15;180(12):1176-87.

Complementary and alternative medicine among veterans and military personnel: a synthesis of population surveys.

Study

Abstract

BACKGROUND: Recent reports reinforce the widespread interest in complementary and alternative medicine (CAM), not only among military personnel with combat-related disorders, but also among providers who are pressed to respond to patient demand for these therapies. However, an understanding of utilization of CAM therapies in this population is lacking. OBJECTIVE: The goals of this study are to synthesize the content of self-report population surveys with information on use of CAM in military and veteran populations, assess gaps in knowledge, and suggest ways to address current limitations. RESEARCH DESIGN: The research team conducted a literature review of population surveys to identify CAM definitions, whether military status was queried, the medical and psychological conditions queried, and each specific CAM question. Utilization estimates specific to military/veterans were summarized and limitations to knowledge was classified. RESULTS: Seven surveys of CAM utilization were conducted with military/veteran groups. In addition, 7 household surveys queried military status, although there was no military/veteran subgroup analysis. Definition of CAM varied widely limiting cross-survey analysis. Among active duty and Reserve military, CAM use ranged between 37% and 46%. Survey estimates do not specify CAM use that is associated with a medical or behavioral health condition. CONCLUSIONS: Comparisons between surveys are hampered due to variation in methodologies. Too little is known about reasons for using CAM and conditions for which it is used. Additional information could be drawn from current surveys with additional subgroup analysis, and future surveys of CAM should include military status variable. PMID: 25397828 [PubMed - in process]

  • Publication Status: Published
  • Sponsoring Organization: DoD agency, office, or organization other than the Army, Navy, Air Force, or Defense Health Agency
  • Sponsoring Office:
  • Congressionally Mandated: No
  • Funding Source: Agency, office or organization under authority of the Sec Def (not affiliated to Army, Navy, or Air Force)
  • Release Date/Publication: December 01, 2014
  • Citation: Davis MT, Mulvaney-Day N, Larson MJ, Hoover R, Mauch D. Complementary and alternative medicine among veterans and military personnel: a synthesis of population surveys. Med Care. 2014 Dec;52 Suppl 5:S83-90.

Day of injury cognitive performance on the Military Acute Concussion Evaluation (MACE) by U.S. military service members in OEF/OIF.

Study

Abstract

OBJECTIVES: The study investigated the clinical validity of the cognitive screening component of the Military Acute Concussion Evaluation (MACE) for the evaluation of acute mild traumatic brain injury (mTBI) in a military operational setting. METHODS: This was a retrospective data study involving analysis of MACE data on Operation Enduring Freedom/Operation Iraqi Freedom deployed service members with mTBI. In total, 179 cases were included in analyses based on ICD-9 diagnostic codes and characteristics of mTBI, and availability of MACE data on day of injury. MACE data from the mTBI group was compared to a military sample without mTBI administered the MACE as part of a normative data project. RESULTS: On day of injury, the mTBI group performed worse than controls on the MACE cognitive test (d = 0.90), with significant impairments in all cognitive domains assessed. MACE cognitive score was strongly associated with established indicators of acute injury severity. Lower MACE cognitive performance on day of injury was predictive of lengthier postinjury recovery time and time until return to duty after mTBI. CONCLUSIONS: Findings from the current study support the use of the MACE as a valid screening tool to assess for cognitive dysfunction in military service members during the acute phase after mTBI.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Defense and Veterans Brain Injury Center
  • Congressionally Mandated: No
  • Funding Source: Undetermined
  • Release Date/Publication: September 01, 2014
  • Citation: McCrea M, Guskiewicz K, Doncevic S, Helmick K, Kennedy J, Boyd C, et.al., . Day of injury cognitive performance on the Military Acute Concussion Evaluation (MACE) by U.S. military service members in OEF/OIF. Mil Med. 2014 Sep;179(9):990-7.

Prevalence, health care utilization, and costs of fibromyalgia, irritable bowel, and chronic fatigue syndromes in the military health system, 2006-2010.

Study

Abstract

OBJECTIVE: We compared prevalence, health care utilization, and costs over time for nonelderly adults diagnosed with fibromyalgia syndrome (FMS), irritable bowel syndrome (IBS), and chronic fatigue syndrome (CFS) in relation to timing of federal approvals for FMS drugs. DATA SOURCE: We used military health care claims from October 2006 to September 2010. STUDY DESIGN/ANALYSIS: Retrospective, multiple-year comparisons were conducted using trend analyses, and time series regression-based generalized linear models. RESULTS: Over 5 years, FMS prevalence rates increased from 0.307% to 0.522%, whereas IBS and CFS prevalence rates remained stable. The largest increase in FMS prevalence occurred between 2007 and 2008. Health care utilization was higher for FMS cases compared to IBS and CFS cases. Over 5 years, the total cost for FMS-related care increased $163.2 million, whereas IBS costs increased $14.9 million and CFS cost increased $3.7 million. Between 2006 and 2010, total pharmacy cost for FMS cases increased from $55 million ($3,641/person) to $96.3 million ($3,557/person). CONCLUSION: Although cause and effect cannot be established, the advent of federally approved drugs for FMS in concert with pharmaceutical industry marketing of these drugs coincide with the observed changes in prevalence, health care utilization, and costs of FMS relative to IBS and CFS.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Defense Health Agency (formerly TRICARE Management Activity)
  • Congressionally Mandated: No
  • Funding Source: Defense Health Agency (formerly TRICARE Management Activity)
  • Release Date/Publication: September 01, 2014
  • Citation: Jeffery DD, Bulathsinhala L, Kroc M, Dorris J. Prevalence, health care utilization, and costs of fibromyalgia, irritable bowel, and chronic fatigue syndromes in the military health system, 2006-2010. Mil Med. 2014 Sep;179(9):1021-9.

Diagnostic Utility of the Posttraumatic Stress Disorder (PTSD) Checklist for Identifying Full and Partial PTSD in Active-Duty Military.

Study

Abstract

The aim of this study was to determine optimally efficient cutoff scores on the Posttraumatic Stress Disorder Checklist (PCL) for identifying full posttraumatic stress disorder (PTSD) and partial PTSD (P-PTSD) in active-duty Marines and Sailors. Participants were 1,016 Marines and Sailors who were administered the PCL and Clinician-Administered PTSD Scale (CAPS) 3 months after returning from Operations Iraqi and Enduring Freedom. PCL cutoffs were tested against three CAPS-based classifications: full PTSD, stringent P-PTSD, and lenient P-PTSD. A PCL score of 39 was found to be optimally efficient for identifying full PTSD. Scores of 38 and 33 were found to be optimally efficient for identifying stringent and lenient P-PTSD, respectively. Findings suggest that the PCL cutoff that is optimally efficient for detecting PTSD in active-duty Marines and Sailors is substantially lower than the score of 50 commonly used by researchers. In addition, findings provide scores useful for identifying P-PTSD in returning service members.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Defense and Veterans Brain Injury Center
  • Congressionally Mandated: No
  • Funding Source: Undetermined
  • Release Date/Publication: September 01, 2014
  • Citation: Dickstein BD, Weathers FW, Angkaw AC, Nievergelt CM, Yurgil K, Nash WP, et.al. . Diagnostic Utility of the Posttraumatic Stress Disorder (PTSD) Checklist for Identifying Full and Partial PTSD in Active-Duty Military. Assessment. 2014 Sep 1.

Providing care to military personnel and their families: how we can all contribute.

Study

Abstract

Providing medical care to members of the military and their families remains a societal duty carried out not only by military physicians but also, and in large part, by civilian providers. As many military families are geographically dispersed, it is probable that all physicians at some point in their training or careers will care for this unique patient population. Understanding the military culture can help physicians provide the best care possible to our military families, and inclusion of military cultural competency curricula in all medical schools is a first step in advancing this understanding. The authors review the knowledge, skills, and attitudes that all health professionals should acquire to be able to care for those who serve and offer recommendations for developing these among all students and trainees.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Uniformed Services University of Health Sciences
  • Congressionally Mandated: No
  • Funding Source: Undetermined
  • Release Date/Publication: September 01, 2014
  • Citation: Gleeson TD, Hemmer PA. Providing care to military personnel and their families: how we can all contribute. Acad Med. 2014 Sep;89(9):1201-3.

Stress and Resilience in Military Mortuary Workers: Care of the Dead From Battlefield to Home.

Study

Abstract

The death of a military service member in war provokes feelings of distress and pride in mortuary workers who process the remains. To further understand their reactions, the authors interviewed 34 military and civilian personnel to learn more about their work stresses and rewards. They review stresses of anticipation, exposure, and experience in handling the dead and explore the personal, supervisory, and leadership strategies to reduce negative effects and promote personal growth. These results can be applied to many other situations requiring planning, implementing, and supervising mortuary operations involving mass death.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Uniformed Services University of Health Sciences
  • Congressionally Mandated: No
  • Funding Source: Undetermined
  • Release Date/Publication: August 01, 2014
  • Citation: Flynn BW, McCarroll JE, Biggs QM. Stress and Resilience in Military Mortuary Workers: Care of the Dead From Battlefield to Home. Death Stud. 2014 Aug 20:1-7.

Three-year outcome following moderate-to-severe TBI in U.S. military service members: a descriptive cross-sectional study.

Study

Abstract

This study examined the prospective course of neurobehavioral symptom reporting and health-related quality of life within the first 3 years following moderate-to-severe traumatic brain injury (TBI). Participants were 52 U.S. service members who were evaluated following a moderate-to-severe TBI sustained in the combat theater during Operations Iraqi and Enduring Freedom (90.4%), or from other noncombat-related incidents. Participants completed the Neurobehavioral Symptom Inventory and Post-Traumatic Stress Disorder-Checklist within 3 months postinjury, and at least one follow-up telephone interview at 12 (n = 27), 24 (n = 31), or 36 months (n = 22) postinjury. Approximately half of the sample (41.9%-63.0%) reported "persistent" symptoms from baseline to follow-up. A substantial minority also "improved" (22.2%-31.8%) or "developed" new symptoms (3.7%-16.1%). Ongoing physical and mental health problems were also reported. The number of service members receiving mental health treatment significantly reduced between 12 and 36 months postinjury (48.1%-18.2%), while complaints of bodily pain significantly increased (40.7%-68.2%). Despite ongoing symptom reporting, few reported suicidal/homicidal ideation (6.5%-9.1%), and a substantial majority reported good/excellent health status (74.1%-90.9%) and satisfaction with their life (81.5%-90.9%). Continued support and care for all service members who sustain a combat-related moderate-to-severe TBI is recommended, regardless of the presence or absence of symptom reporting within the first few months postinjury.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Defense and Veterans Brain Injury Center
  • Congressionally Mandated: No
  • Funding Source: Defense Health Agency (formerly TRICARE Management Activity)
  • Release Date/Publication: August 01, 2014
  • Citation: Brickell TA, Lange RT, French LM. Three-year outcome following moderate-to-severe TBI in U.S. military service members: a descriptive cross-sectional study. Mil Med. 2014 Aug;179(8):839-48.

Opiate-related dependence/abuse and PTSD exposure among the active-component U.S. military, 2001 to 2008.

Study

Abstract

BACKGROUND: Over the past 5 years, diagnoses for opiate abuse or dependency and post-traumatic stress disorder (PTSD) have increased across all U.S. military services. Moreover, in the United States, opiate prescription dependence and abuse has now surpassed all other illicit drugs of abuse with the exception of marijuana. Some research indicates that PTSD is predictive of substance dependence and abuse, while other research suggests that substance dependence and abuse may lead to events that trigger PTSD. This dichotomy has not been extensively explored within a military population. METHODS: Using conditional multiple logistic regression analysis, a matched case-control study with 18,606 active-component U.S. military service members was conducted to examine the relationship between opiate dependence or abuse and PTSD. RESULTS: Among the 18,606 service members included in the analysis, 21% were cases and 79% were controls. Thirteen percent of service members with substance dependence or abuse diagnosis had a prior PTSD diagnosis compared to 1% of controls. After, adjusting for sociodemographic and military characteristics, the odds of having a prior diagnosis of PTSD was 28 (95% CI: 21.24-37.78) times greater for service members with opiate abuse/dependency compared to controls. CONCLUSION: These findings suggest active duty military personnel diagnosed with PTSD should be closely monitored to reduce the likelihood of future morbidity because of opiate dependence or abuse.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Armed Forces Health Surveillance Center
  • Congressionally Mandated: No
  • Funding Source: Army
  • Release Date/Publication: August 01, 2014
  • Citation: Dabbs C, Watkins EY, Fink DS, Eick-Cost A, Millikan AM. Opiate-related dependence/abuse and PTSD exposure among the active-component U.S. military, 2001 to 2008. Mil Med. 2014 Aug;179(8):885-90.
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