Cumulative Incidence of Post-Traumatic Stress Disorder and Other Mental Disorders
The health needs, including mental health needs, of military personnel are a priority for the Government of Canada and the Canadian Forces.
The Canadian Forces Health Services Group is committed to the care and support of our men and women in uniform. As part of this commitment, health services conducts leading edge research in the area of post-deployment mental health.
The Cumulative Incidence of PTSD and Other Mental Disorders study provides a reliable estimate of deployed personnel who have been formally diagnosed with conditions related to deployment such as PTSD, over an average of almost five years of follow-up.
It allows the CF to better understand the overall psychological impact of the mission in Afghanistan on the CF and its personnel and will inform research, policy and program development.
The study will also allow the CF leadership to better understand the health of its personnel following deployment.
Alert: Canadian Forces Information
This study uses CF administrative data. Therefore, there is no requirement for current or retired personnel to register or volunteer.
Q. What is the Cumulative Incidence of PTSD and Other Mental Health Disorders study?
A. The Cumulative Incidence of PTSD and Other Mental Health Disorders study provides a reliable estimate of deployed personnel who have been formally diagnosed with conditions related to deployment such as post-traumatic stress disorder (PTSD), over an average of almost five years of follow-up. It allows the CF to better understand the overall psychological impact of the mission in Afghanistan on the CF and its personnel. Initial results have been posted on the CFHS website.
Q. Why was the study conducted?
A. Under the direction of the Surgeon General, CF Health Services Group conducted the study to better understand the overall psychological impact of the mission in Afghanistan. While previous studies provided a picture of some of the psychological effects of the Afghanistan mission on CF personnel, information estimating the total percentage of personnel actually diagnosed with PTSD was not available.
Q. Who was included in the study?
A. The study group included all CF members enrolled in the Regular or Primary Reserve Forces, who returned from deployment of any duration in support of the mission in Afghanistan between Oct. 1, 2001 and Dec. 31, 2008. The CF identified 30,518 such personnel and examined the medical records of a random sample group of 2,045 personnel.
The study group was broken down as follows:
- Sex: 90 per cent male, 10 per cent female
- Mean age: 36 years
- Component: 89 per cent Regular Force members, 11 per cent Reserve Force members
- Environment: 64 per cent Land, 17 per cent Sea, 19 per cent Air
- Rank: 17 per cent Officer, 31 per cent Senior Non-Commissioned Member, 52 per cent Junior Non-Commissioned Member
The breakdown of the deployment locations were as follows:
- Kandahar: 41.8 per cent
- Arabian Gulf: 17.2 per cent
- Multiple locations: 15.3 per cent
- Kabul or elsewhere in Afghanistan: 13.6 per cent
- Camp Mirage or elsewhere in Southwest Asia: 10.2 per cent
- Unspecified location: 1.9 per cent
Q. What was the key finding of the study?
A. The initial findings of the Cumulative Incidence of PTSD and Other Mental Health Disorders study estimates that eight per cent of personnel who deployed in support of the mission in Afghanistan were diagnosed with mission-related PTSD. An additional 5.2 per cent or personnel were diagnosed with Afghanistan-related mental health disorders other than PTSD (for example, depression).
Q. What is this difference between this study and the previous post-deployment studies?
A. Previous figures were based largely on information from post-deployment screening questionnaires and pertained only to particular subsets of the deployed population. This information provides self-reported symptoms associated with PTSD three to six months after deployment, but not a confirmed diagnosis. This study is the first to provide an estimate of actual PTSD in CF personnel deployed in support of the mission since its inception and over a prolonged period of follow-up.
Q. Are the results of this study surprising?
A. No. The results reflect the difficult nature of the mission. Previous estimates were based on post-deployment screening and not all cases or symptoms would have presented at this time. It was expected that more cases would present as time elapsed. This increase in numbers with the current study is reflective of cases that had an opportunity to be diagnosed up to an average of 55 months following deployment.
Q. How do these rates compare to those of our allies?
A. There are no truly comparable studies from our allies, so direct comparison is impossible. However, once differences in the study populations and the methods used are taken into account, the results are consistent with those of many studies of difficult conflicts, past and present. As an example, most international studies have concluded that highest risk group is Junior Non-Commissioned Members from the combat arms trades that have been exposed to combat. This study also reflects that this group was at highest risk.
Q. How is PTSD addressed in the CF?
A. CFHS provides timely comprehensive evidence-based assessment and treatment of all health conditions including PTSD. Treatment is individualized and delivered by our interdisciplinary teams. Depending on needs individual, group or couple counseling may be offered as well as medications. Many of those diagnosed with PTSD in the CF respond to treatment and return to full duties, while some remain in the CF with some modification to their duties. Those who do not respond fully to treatment and that are unable to remain in the CF are transitioned to the care of Veterans Affairs Canada. The CF also has a comprehensive pre- and post-deployment program to assist soldiers dealing with the challenges of a deployment.
Q. Why are the results of this study significant?
A. This study provides the most rigorous scientific estimate of CF personnel diagnosed with PTSD following their deployment in Afghanistan.
Q. What are the next steps?
A. Data collected during this study will be used for further analysis, notably:
- To project rates and numbers of mental health diagnoses into the near future
- To evaluate the quality of care provided
- To determine the treatment outcome of those diagnosed.
Q. Are there any privacy risks associated with this study?
A. No. Information collected on health is stored and analysed according to the strict privacy rules and regulations. Details of a member's health are confidential and cannot be disclosed under the Privacy Act.
Q. Where can I get more information?
A. The report is available on the CF Health Services website. For more information, please submit a public inquiry through DND at 613-995-2534 or online. For information on the CF’s pre- and post-deployment mental health training program, The Road to Mental Readiness (R2MR), please visit the R2MR website. The site provides pre- and post- deployment-related resources for CF members, families and health service providers.
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