The results suggest that screening for PTSD symptoms should continue
for more than just a year or two after soldiers return home because
new or recurrent PTSD cases could emerge, the authors say.
“Our objective was to gain more insight in the changes in
posttraumatic stress complaints in a long-term period after
deployment, ultimately to evaluate the timing of an increase in
treatment demand after deployment,” said lead author Iris Eekhout of
VU University Medical Center in Amsterdam, by email.
In the U.S., 11 to 20 percent of veterans of the Iraq war suffer
PTSD symptoms each year, according to the Department of Veterans
These symptoms can include nightmares or flashbacks to traumatizing
events, feelings of fear, guilt or shame, or being hyper-alert and
having trouble concentrating.
While many studies have looked at short-term mental health effects
for veterans, there has been less focus on the timing of long-term
developments, Eekhout told Reuters Health.
She and her colleagues analyzed data on 1,007 Dutch soldiers
deployed to Afghanistan between March 2005 and September 2008. Most
of the soldiers had not been deployed before.
Soldiers were first assessed roughly one month before leaving for
what would be an average four-month deployment. One month after
returning home, and then at six months, one year, two years and five
years later, the soldiers filled out questionnaires again.
Compared with pre-deployment levelsOverall, the average level of
PTSD symptoms increased during the first six months after the
soldiers returned home.
One year after returning, the average level of symptoms tended to
drop back to the pre-deployment level. However, there was another
increase five years after the soldiers returned, which was larger
than at all previous times.
Soldiers younger than 21 when they deployed had a greater increase
in PTSD symptoms than older soldiers at both the one-year and
Soldiers with combat duties outside the military base also had
significantly more PTSD symptoms at one year and five years than
those who only resided inside the military base during their
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Eekhout noted that belonging to a military group and feeling safety
and understanding might help people cope with traumatic experiences.
“However, when over time the connection to a military group
diminishes, resilience may wear off as well, contributing to a
delayed stress response,” she said.
The study team writes in The Lancet Psychiatry that soldiers may not
experience the onset of their symptoms until later simply because
stress symptoms are not “adaptive” - meaning they don’t help matters
- during combat situations.
Don Richardson, a consultant psychiatrist for the Parkwood
Operational Stress Injury Clinic in Ontario, Canada, noted that PTSD
is often accompanied by other conditions like depression, anxiety
and substance use disorders. “Therefore it is important to better
understand how PTSD symptoms change over time in the context of
other mental health symptoms,” he said.
Richardson advises primary care physicians to ask patients if
they're veterans, because those who are might be at a greater risk
for undiagnosed PTSD.
“Screening and diagnosis is important as there are effective
pharmacologic and psychological treatments available for PTSD,”
Eekhout emphasized the importance of keeping in contact with
deployed soldiers and ensuring that they have easy access to mental
“It is important to monitor their psychological health for a long
time after deployment, because early detection of symptoms is
essential to early treatment, which is related to positive outcome,”
SOURCE: bit.ly/1NxNkGX The Lancet Psychiatry, online December 8,
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