Prevalence of common mental health disorders in military veterans: using primary healthcare data
Abstract: Introduction: Serving military personnel and military veterans have been identified as having a high prevalence of mental disorders. Since 1985, UK patients’ primary healthcare (PHC) medical records contain Read Codes (now being replaced by Systematized Nomenclature of Medicine - Clinical Terms (SNOMED CT) codes) that mark characteristics such as diagnosis, ethnicity and therapeutic interventions. This English study accesses a cohort profile of British Armed Forces veterans to examine the diagnosed common mental disorders by using PHC records. Methods: This analysis has been drawn from initiatives with PHC practices in the Northwest of England to increase veteran registration in general practice. Demographic data were collected including gender, age and marital status. Data were also collected on common mental health disorders associated with the Armed Forces. Result: 2449 veteran PHC records were analysed. 38% (N=938) of veterans in this cohort had a code on their medical record for common mental health disorders. The highest disorder prevalence was depression (17.8%, N=437), followed by alcohol misuse (17.3%, N=423) and anxiety (15.0%, N=367). Lower disorder prevalence was seen across post-traumatic stress disorder (PTSD) (3.4%, N=83), dementia (1.8%, N=45) and substance misuse (0.8%, N=19). Female veterans had a higher prevalence of mental disorders than their male counterparts, while men a higher prevalence of PTSD; however, the gender difference in the latter was not significant (p>0.05). Conclusion: The SNOMED searches do not detail why certain groups had higher recordings of certain disorders. A future study that accesses the PHC written medical notes would prove enlightening to specifically identify what situational factors are having the most impact on the veteran population. The results from a sizeable English veteran population provide information that should be considered in developing veteran-specific clinical provision, educational syllabus and policy.
Abstract: The unique demands of military life can adversely impact romantic relationships; however, research has mainly focused on these adverse outcomes at one-time point, overlooking changes over time or potential positive outcomes. Using a subsample of 3,845 male and female military personnel and veterans from a large UK dataset, this study examined positive and negative changes in relationship satisfaction between two-time points (2007–2009; 2014–2016). Most participants reported no change in their relationship satisfaction, suggesting stability − 8% reported a positive change and 10% a negative change. Positive change was associated with being in a long-term relationship, alcohol misuse remission, and persistent alcohol misuse. Negative change was associated with the onset of mental health problems (probable PTSD, CMD, or alcohol misuse) and having children under 18. Some factors, like increasing age, childhood family relationship adversity, and mental health problems, were associated with both positive and negative changes in relationship satisfaction. This study highlights the complexity of factors associated with relationship satisfaction among military personnel and veterans, with some experiencing positive changes, as well as negative changes over time.