The European Journal of Public Health Advance Access published online on May 8, 2008
The European Journal of Public Health, doi:10.1093/eurpub/ckn031
Do medical services personnel who deployed to the Iraq war have worse mental health than other deployed personnel?*
Margaret Jones1, Nicola T. Fear2, Neil Greenberg2, Norman Jones2, Lisa Hull1, Matthew Hotopf1, Simon Wessely1 and Roberto J. Rona1
1 King's Centre for Military Health Research, Institute of Psychiatry, King's College London, London, UK
2 Academic Centre for Defence Mental Health, Institute of Psychiatry, King's College London, London, UK
Correspondence: Margaret Jones, King's Centre for Military Health Research, Weston Education Centre, Cutcombe Road, London, SE5 9RJ, tel: 020 7848 5594, fax: 020 7848 5408, e-mail: margaret.jones{at}kcl.ac.uk
Received February 6, 2008 , accepted March 31, 2008
Aim: There is evidence of increased health care utilization by medical personnel (medics) compared to other trades in the UK Armed Forces. The aim of this study was to compare the burden of mental ill health in deployed medics with all other trades during the Iraq war. Methods: Participants’ main duty during deployment was identified from responses to a questionnaire and verified from Service databases. Psychological health outcomes included psychological distress, post-traumatic stress disorder, multiple physical symptoms, fatigue and heavy drinking. Results: A total of 479 out of 5824 participants had a medical role. Medics were more likely to report psychological distress (OR 1.30, 95% CI 1.00–1.70), multiple physical symptoms (OR 1.65, 95% CI 1.20–2.27) and, if men, fatigue (1.38, 95% CI 1.05–1.81) than other personnel. Female medics were less likely to report fatigue (0.57 95% CI 0.35–0.92). Neither post-traumatic stress disorder nor heavy drinking symptoms were associated with a medical role. Traumatic medical experiences, lower group cohesion and preparedness, and post-deployment experiences explained the positive associations with psychological ill health. Medics made greater use of medical facilities than other trades. Conclusions: There is a small excess of psychological ill health in medics, which can be explained by poorer group cohesion, traumatic medical and post-deployment experiences. The association of mental ill health with a medical role was not the consequence of a larger proportion of reservists in this group.
Keywords: Iraq, medical personnel, mental health, military
*In this article, UK military medical personnel including doctors, nurses and medical support staff are referred to collectively as medics.