Differences Among U.S. Military Personnel Evacuated for Psychiatric Conditions from the Iraq and Afghanistan Combat...

The U.S. military launched various combat operations following the September 11, 2001 terrorist attack on America. This included Operation Enduring Freedom (OEF) in and around Afghanistan and Operation Iraqi Freedom (OIF) in and around Iraq. These operations occurred in different locations and timeframes and had a significantly different number of casualties. Little is known about the psychological impact of these operations among service members. This study evaluated differences in mental health diagnoses and suicide risk among individuals evacuated for psychiatric conditions from these 2 theaters of combat.

Data was retrieved from U.S. Transportation Command Regulating and Command and Control Evacuation System and Defense Manpower Data Center records of services members who were aeromedically evacuated for psychiatric conditions during OEF (n = 2,920) and OIF (n = 4,832) between 2001 and 2013 (N = 7,752). We computed Pearson chi-squares to identify differences between service members who had a psychiatric aeromedical evacuation from OEF versus OIF. We evaluated differences in (1) demographic and military characteristics, (2) the prevalence of psychiatric conditions, (3) the 5 most common primary diagnoses, (4) indicators of suicide risk, and (5) the relationship of suicide risk with separation from military service.

There were significant differences in those who had a psychiatric aeromedical evacuation from OEF and OIF related to marital status (χ2(2) = 10.99, P = .004) and education (χ2(3) = 21.29, P < .001). The prevalence of diagnosed psychiatric conditions also differed between OEF and OIF (χ2(10) = 263.49, P < .001). There were no differences in the distribution of suicide attempts, but there was a significant difference in the number of aeromedical evacuations attributed to suicidal ideation (χ2(1) = 182.705, P < .001).

Significant differences were identified in service members who had a psychiatric aeromedical evacuations from OEF and OIF regarding demographic factors and military characteristics. Even though fewer services members were evacuated for suicidal ideations during OIF, a higher number of services members were evacuated for suicide attempts. This inverse trend may be attributable to deployment stressors or healthcare services differences delivered in theater. Similarly, this may explain the difference in the prevalence of diagnosed conditions.