Major Finding: 37% of wives whose husbands were deployed received a mental health diagnosis, compared with 30% of wives whose husbands were not deployed.
Data Source: Records of all outpatient medical visits of wives of active-duty Army personnel between 2003 and 2006.
Disclosures: Dr. Mansfield reported no conflicts, but a coauthor reported relationships with Bristol-Myers Squibb and Novartis. Dr. Friedman had no relevant disclosures.
Wives of U.S. soldiers deployed to Iraq or Afghanistan for prolonged periods are at increased risk for receiving mental health diagnoses, compared with wives of nondeployed personnel, according to a recent report.
The higher risk was most apparent for depressive, anxiety, sleep, and acute stress reaction and adjustment disorders, said Alyssa J. Mansfield, Ph.D., of the University of North Carolina, Chapel Hill, and her associates.
“Overall, our data suggest that the mental health effects of current operations are extending beyond soldiers and into their immediate families,” the investigators noted.
Dr. Mansfield and her colleagues examined the records of all outpatient medical visits by wives of active-duty Army personnel between 2003 and 2006. This included wives who were treated at military facilities and those who were treated at nonmilitary health centers but used military medical insurance.
Only wives of members of the military who had been in active-duty service for at least 5 years were included in the study “to establish a recent mental health history.”
The study sample included 250,626 women who made 6,585,224 outpatient medical visits. Seventeen categories of mental health disorders were assessed. A total of 35% of these wives received at least one mental health diagnosis during the 4-year study.
A total of 37% of wives whose husbands were deployed received a mental health diagnosis, compared with 30% of wives whose husbands were not deployed, the researchers said (N. Engl. J. Med. 2010;362:101–9).
Wives of men who were deployed showed rates of diagnosis that were 24% higher for depressive disorders, 21%–40% higher for sleep disorders, 25%–29% higher for anxiety disorders, and 23%–39% higher for acute stress reaction and adjustment disorders, compared with wives of nondeployed men.
The rate of mental health diagnosis was significantly associated with length of husbands' deployment. Compared with wives of men who were not deployed, wives of men deployed for up to 11 months used mental health services 19% more often, and wives of men deployed for more than 11 months used mental health services 27% more often.
There were 41 excess cases of any mental health disorder (per 1,000 wives) associated with deployments of 1–11 months, and 61 excess cases of any mental health disorder associated with deployments of more than 11 months.
This represents 3,474 excess mental health diagnoses among nearly 85,000 wives of men deployed for less than 11 months and 5,370 excess mental health diagnoses among more than 88,000 wives of men deployed for a longer period.
“Because the majority of active-duty Army soldiers are married, and they and their families will eventually receive care outside the military medical system, both the short-term and long-term effects of these findings should be considered” by health care providers both inside and outside of the military, Dr. Mansfield and her associates said.
In an editorial comment accompanying this report, Dr. Matthew J. Friedman of the Veterans Affairs Medical Center in White River Junction, Vt., said the study findings highlight the importance of “developing appropriate programs to fortify wellness and resilience among spouses and children.”
“Since social support provides the strongest protection against the development of psychiatric disorders, and since the family is the major source of social support, improvement in the mental health of spouses and children should also pay dividends in improving the mental health of troops throughout the deployment cycle,” Dr. Friedman said (N. Engl. J. Med. 2010:362;168–70).