TY - JOUR
T1 - Long-term trajectories of depressive symptoms in deployed military personnel
T2 - A 10-year prospective study
AU - Plas, Xandra
AU - Bruinsma, Bastiaan
AU - van Lissa, Caspar J
AU - Vermetten, Eric
AU - van Lutterveld, Remko
AU - Geuze, Elbert
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2024/6/1
Y1 - 2024/6/1
N2 - Background: Military missions, especially those involving combat exposure, are associated with an increased risk of depression. Understanding the long-term course of depressive symptoms post-deployment is important to improve decision-making regarding deployment and mental health policies in the military. This study investigates trajectories of depressive symptoms in the Dutch army, exploring the influence of factors such as demographics, early-life trauma, posttraumatic stress disorder (PTSD) symptoms, and deployment stressors. Methods: A cohort of 1032 military men and women deployed to Afghanistan (2005–2008) was studied from pre- to 10 years post-deployment. Depressive and PTSD symptoms were assessed using the Symptom CheckList-90 and the Self-Rating Inventory for PTSD. Demographics, early trauma, and deployment experiences were collected at baseline and after deployment, respectively. Latent Class Growth Analysis was used to explore heterogeneity in trajectories of depressive symptoms over time. Results: Four trajectories were found: resilient (65%), intermediate-stable (20%), symptomatic-chronic (9%), and late-onset-increasing (6%). The resilient group experienced fewer deployment stressors, while the symptomatic-chronic group reported more early life traumas. Trajectories with elevated depressive symptoms consistently demonstrated higher PTSD symptoms. Limitations: Potential nonresponse bias and missing information due to the longitudinal design and extensive follow-up times. Conclusions: This study identified multiple trajectories of depressive symptoms in military personnel up to 10 years post-deployment, associated with early trauma, deployment stressors, adverse life events and PTSD symptoms. The prevalence of the resilient trajectory suggests a substantial level of resilience among deployed military personnel. These findings provide valuable insights and a foundation for further research.
AB - Background: Military missions, especially those involving combat exposure, are associated with an increased risk of depression. Understanding the long-term course of depressive symptoms post-deployment is important to improve decision-making regarding deployment and mental health policies in the military. This study investigates trajectories of depressive symptoms in the Dutch army, exploring the influence of factors such as demographics, early-life trauma, posttraumatic stress disorder (PTSD) symptoms, and deployment stressors. Methods: A cohort of 1032 military men and women deployed to Afghanistan (2005–2008) was studied from pre- to 10 years post-deployment. Depressive and PTSD symptoms were assessed using the Symptom CheckList-90 and the Self-Rating Inventory for PTSD. Demographics, early trauma, and deployment experiences were collected at baseline and after deployment, respectively. Latent Class Growth Analysis was used to explore heterogeneity in trajectories of depressive symptoms over time. Results: Four trajectories were found: resilient (65%), intermediate-stable (20%), symptomatic-chronic (9%), and late-onset-increasing (6%). The resilient group experienced fewer deployment stressors, while the symptomatic-chronic group reported more early life traumas. Trajectories with elevated depressive symptoms consistently demonstrated higher PTSD symptoms. Limitations: Potential nonresponse bias and missing information due to the longitudinal design and extensive follow-up times. Conclusions: This study identified multiple trajectories of depressive symptoms in military personnel up to 10 years post-deployment, associated with early trauma, deployment stressors, adverse life events and PTSD symptoms. The prevalence of the resilient trajectory suggests a substantial level of resilience among deployed military personnel. These findings provide valuable insights and a foundation for further research.
KW - Long-term depression
KW - Military personnel
KW - PTSD
KW - Trajectories
UR - http://www.scopus.com/inward/record.url?scp=85188987360&partnerID=8YFLogxK
U2 - 10.1016/j.jad.2024.03.139
DO - 10.1016/j.jad.2024.03.139
M3 - Article
C2 - 38537760
AN - SCOPUS:85188987360
SN - 0165-0327
VL - 354
SP - 702
EP - 711
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -