Risk factors for positive depression screening across a shipboard deployment cycle

Area of Science:

• Military Health
• Psychiatry
• Epidemiology

Background:

• Depression is a significant cause of healthcare use and suicide risk in US military personnel.
• Shipboard deployments present unique challenges for mental health characterization and screening compared to land-based operations.
• Early identification of depression risk is hindered by less frequent screening during shipboard deployments.

Purpose of the Study:

• To identify demographic and behavioral risk factors for screening positive for risk of depression (ROD) throughout the shipboard deployment cycle.
• To understand the prevalence and predictors of depression risk in active-duty personnel on ships.

Main Methods:

• Anonymous assessments using the Center for Epidemiologic Studies Depression Scale (CES-D) were administered to ship-assigned personnel.
• Data were collected in the year prior to, during, and following deployment.
• Longitudinal models were employed to analyze risk factors associated with depression risk.

Main Results:

• Over 50% of the 598 participants screened positive for ROD (CES-D score ≥16) at all time points.
• More than 25% screened positive for risk of major depressive disorder (CES-D score ≥22) across the deployment cycle.
• Lower age, female gender, alcohol use, stress, and prior mental health diagnoses were significantly associated with increased odds of ROD.

Conclusions:

• The prevalence of depression risk screening positive exceeds previously reported figures in military and civilian populations.
• Risk factors identified are consistent with other populations, but the high prevalence suggests unique stressors associated with shipboard deployment.
• Shipboard environments may exacerbate depressive symptoms or increase their likelihood due to specific deployment-related factors.