兵士の派遣、その妻の精神疾患増と関連

兵士の派遣、その妻の精神疾患増と関連、米国調査

2010年01月18日 ソース:NEJM(論文一覧) カテゴリ:精神科疾患(関連論文

文献:Mansfield AJ et al. Deployment and the Use of Mental Health Services among U.S. Army Wives. NEJM. 2010;362:101-109

『イラクの自由作戦』とアフガニスタンの『不朽の自由作戦』に派遣された米国陸軍兵士の妻250626名の外来診療カルテを分析。派兵とその期間が、妻の精神疾患(抑うつ障害、睡眠障害、不安、急性ストレス反応、適応障害など)と関連するか検討した。その結果、派兵の長期化に伴い、精神疾患と診断される割合が増加することが示された。

Deployment and the Use of Mental Health Services among U.S. Army Wives

Alyssa J. Mansfield, Ph.D., M.P.H., Jay S. Kaufman, Ph.D., Stephen W. Marshall, Ph.D., Bradley N. Gaynes, M.D., M.P.H., Joseph P. Morrissey, Ph.D., and Charles C. Engel, M.D., M.P.H.

   

ABSTRACT

Background Military operations in Iraq and Afghanistan have involved the frequent and extended deployment of military personnel, many of whom are married. The effect of deployment on mental health in military spouses is largely unstudied.

Methods We examined electronic medical-record data for outpatient care received between 2003 and 2006 by 250,626 wives of active-duty U.S. Army soldiers. After adjustment for the sociodemographic characteristics and the mental health history of the wives, as well as the number of deployments of the personnel, we compared mental health diagnoses according to the number of months of deployment in Operation Iraqi Freedom in the Iraq–Kuwaitregion and Operation Enduring Freedom in Afghanistan during the same period.

Results The deployment of spouses and the length of deployment were associated with mental health diagnoses. In adjusted analyses, as compared with wives of personnel who were not deployed, women whose husbands were deployed for 1 to 11 months received more diagnoses of depressive disorders (27.4 excess cases per 1000 women; 95% confidence interval [CI], 22.4 to 32.3), sleep disorders (11.6 excess cases per 1000; 95% CI, 8.3 to 14.8), anxiety (15.7 excess cases per 1000; 95% CI, 11.8 to 19.6), and acute stress reaction and adjustment disorders (12.0 excess cases per 1000;95% CI, 8.6 to 15.4). Deployment for more than 11 months was associated with 39.3 excess cases of depressive disorders (95% CI, 33.2 to 45.4), 23.5 excess cases of sleep disorders (95% CI, 19.4 to 27.6), 18.7 excess cases of anxiety (95% CI, 13.9 to 23.5), and 16.4 excess cases of acute stress reaction and adjustment disorders (95% CI, 12.2 to 20.6).

Conclusions Prolonged deployment was associated with more mental health diagnoses among U.S. Army wives, and these findings may have relevance for prevention and treatment efforts.