Poor health prior to combat linked to later PTSD

Post-traumatic stress disorder (PTSD) after deployment is more likely to affect soldiers who have relatively poor physical or mental health before they enter combat situations, according to findings from the US military's Millennium Cohort Study.

"More vulnerable members of a population could be identified and benefit from interventions targeted to prevent new onset post-traumatic stress disorder," the research team, led by Dr. Cynthia A. LeardMann at the Naval Health Research Center, San Diego, states in an Online First issue of the British Medical Journal.

Their study included 5410 military personnel who completed a health survey before and after deployment to combat duty in Iraq or Afghanistan.

"The largest risk factor for developing new onset PTSD in this study was low mental health scores at baseline before deployment," the authors report.

The team found that those in the lowest strata for mental health before deployment were three times more likely than the rest of the group to develop PTSD subsequently.

"Nearly as surprising," the report adds, there was two-fold increase in risk among those in the lowest ranking for physical health.

In fact, 58 percent of those with PTSD fell into the lower levels for mental or physical health at baseline.

"In theory," LeardMann and her group suggest, soldiers predicted to be at high risk for PTSD "could be targeted for PTSD prevention programmes, early intervention after exposure to stress, or even protection from stressful exposures, when possible."

SOURCE: BMJ Online First, April 17, 2009.