Estimating Rates Of Post Traumatic Stress Disorder
Ohio’s National Guardsmen and Reserve head off to war armed with more than their combat skills. Ohio leaders have led the nation in shielding its citizen-soldiers from battlefield stress with mental health support to protect them from the trauma of war before and after deployment.
Psychiatry researchers at the University Hospitals Case Medical Center (UHCMC), Case Western Reserve University School of Medicine, the University of Toledo Health Science Campus and the University of Michigan are collaborating on an ongoing study of Post-Traumatic Stress Disorder (PTSD) for their own National Guard and Reserve soldiers.
The research team is working on a multiyear, $12 million U.S. Department of Defense-funded research project – the first of its kind in U.S. history – involving the Ohio National Guard and two primary sites, UHCMC and the University of Toledo Medical Center. In this project, “risk and resilience factors” for the development of PTSD and other mental illnesses among Ohio’s citizen-soldiers are carefully being detailed at baseline and then during long-term follow-up in 3,000 members of the Guard, before and after deployment.
The first 821 of the 3,000 service members projected for enrollment have received one-hour research telephone interviews that will be followed up by yearly assessments up to 2019. About 500 of those participants are also being randomly selected to complete detailed, two to three hour in-person assessments. Of the 821 service members studied to date, 521 had been deployed an average of about two years ago. Eight percent of the 202 deployed to Iraq met criteria for current/ongoing PTSD as compared to five percent of the 107 deployed to other theaters of the global war on terror, one percent of the 115 deployed within the U.S. to assist in domestic emergencies, and none of the 26 deployed to Afghanistan.
“Contrary to popular opinion, guard members experienced substantial trauma, probably as much trauma as the Active Component (regular full-time service members),” said principal investigator Joseph R. Calabrese, director of the Mood Disorders Program at UHCMC and professor of psychiatry and co-director of the Bipolar Disorders Research Center at the Case Western Reserve University School of Medicine.
“We have a good idea regarding risk factors for the development of PTSD. However, less is known about why the majority of soldiers who experience combat stress do not develop PTSD,” said Marijo Tamburrino, co-principal investigator of the study and professor and chair of psychiatry at the University of Toledo.
Preliminary findings show that Guard members appear “remarkably resilient” to the development of PTSD, major depression and generalized anxiety after an average lapse of two years time from the Guard member’s last deployment. Training, preparedness, and pre- and post-deployment mental health support also appear to be predictors of resilience to PTSD following combat within the Ohio National Guard.
The state of Ohio provides its National Guard and Reserve soldiers deployed to Iraq and Afghanistan the essential mental health support and resources before and after they return from battle overseas through the state’s OHIOCARES program, a collaboration of state agencies led by the Ohio National Guard that provides a behavioral health safety support for members of the military and their families.
“The state has really stepped up in trying to help our Guard and Reserve adjust to deployment and readjust once they return,” Calabrese said. “These soldiers are subjected to significant trauma. Ohio is way ahead of the national curve in delivering the mental health resources and support to our citizen-soldiers through the Warrior 360 and OHIOCARES programs.”
The prevalence of PTSD in the general population increases with age, yet tends to level off and decrease in people aged 60 years and older, Calabrese says. The lifetime prevalence by decade of life of PTSD is 6.3 percent for 18-29 year-olds; 8.2 percent for 30-44 year-olds, and 9.2 percent for 45-59 year-olds. Adjusted for gender, the lifetime prevalence of PTSD is about 9.7 percent for women and 3.6 percent for men.
The project, known as the Kaptur Combat Mental Health Initiative, is being championed by U.S. Rep. Marcy Kaptur of Toledo, who brought together the team of investigators and worked with the Department of Defense to provide the resources for the Ohio-based research and treatment.
“Ohio will serve as a national model to evaluate the largest sample of returning veterans ever undertaken by the Department of Defense in cooperation with the Ohio National Guard,” said Congresswoman Kaptur. “The goal is to identify these conditions, study their onset, and treatment, and do everything possible to alert Ohio vets that care is available if they are experiencing these conditions.
“When these soldiers return home, they are returned not to an active duty base with nearby hospitals and medical care, but to home communities that often lack medical services for careful follow on diagnosis and treatment.”