Factors That Contribute to Mental Health in Combat Injured Military Women

Abstract

Background: As military women enter roles directly related to combat, they will have greater risk of injury. The present study examined the prevalence of mental health conditions among female service members one year postinjury, and analyzed factors which may place women at risk for mental health concerns and lower quality of life (QOL). Methods: A total of 1,012 U.S. servicewomen who sustained combat-related injury in Iraq and Afghanistan were identified from the Expeditionary Medical Encounter Database (EMED). Injury severity was calculated and QOL scores were collected from a subset of the women. Injury severity, military occupation, branch of service, age, rank, marital status, number of deployments, initial treatment facility, and environment of care were collected as predictor variables. The Military Health System Data Repository was queried for mental health International Classification of Diseases, 9th and 10th Revision codes occurring within one year postinjury. Results: Within the first year postinjury, 404 women (40%) were diagnosed with mental health conditions. The most common were posttraumatic stress disorder (PTSD), (n = 203, 20%), depressive disorders (n = 123, 12.1%), adjustment disorders (n = 92, 9.0%), and anxiety disorders (n = 81, 8.0%). Logistic regression identified that women with minor or moderate injuries had lower odds of mental health diagnoses. Occupation categories of combat support and communications predicted fewer mental health issues. Enlisted women had increased risk of mental health issues. Linear regression showed that officers had higher QOL compared with enlisted women 0.055 (95% CI, 0.005-0.183), p<.05. Women serving in the Air Force had higher QOL postinjury 0.119 (95% CI, .055-.183), p<.000. An independent samples t-test showed that women with mental health diagnoses postinjury (M = 0.46, SD = 0.12) had significantly lower QOL scores (range 0-1) compared to those without mental health diagnoses (M = 0.52, SD = 0.13), t(3.46), p <.05. Conclusions: These findings showed that PTSD, depression, adjustment disorder, and anxiety comprise the most prevalent mental health diagnoses in this population. QOL is significantly lower in injured women with mental health issues after injury. Further research is needed to discover strategies for maintaining optimum health in this population.