U.S. Naval and Marine Corps Occupations, Posttraumatic Stress Disorder, Depression Risk, and Absenteeism

Abstract

For the Millennium Cohort Study Team

Little is known of the association between military occupation and posttraumatic stress disorder (PTSD) or depression and the relations between these conditions and lost workdays. The objective of this study was to determine if military occupation is associated with PTSD or depression. A secondary objective was to determine if PTSD or depression was associated with lost workdays. Occupations for U.S. Navy and Marine Corps personnel were classified according to Department of Defense definitions. The 17-item PTSD Checklist-Civilian version was used to assess PTSD, whereas depression status was assessed using the nine-item Patient Health Questionnaire. Navy personnel in service and supply occupations were at greater odds of reporting PTSD, whereas those serving in health care were at greater odds of reporting depression. Individuals reporting new-onset or persistent PTSD or depression had about twice the odds of reporting lost workdays. PTSD and depression were positively associated with lost workdays, suggesting that early identification and management of these conditions may improve readiness.

KEYWORDS:

• depression
• military personnel
• occupational diseases
• posttraumatic stress disorder

ACKNOWLEDGMENTS

Millennium Cohort Study Team Members: Melissa Bagnell, MPH; Gina Creaven, MBA; Nancy Crum-Cianflone, MD, MPH; James Davies, BS; Gia Gumbs, MPH; Nisara Granado, MPH, PhD; Lesley Henry, BA; Dennis Hernando, BS; Jaime Horton, BS; Isabel Jacobson, MPH; Kelly Jones, MPH; Lauren Kipp, BA; Cynthia LeardMann, MPH; William Lee; Michelle Linfesty; Gordon Lynch; Hope McMaster, PhD; Sheila Medina-Torne, MPH; Amanda Pietrucha, MPH; Teresa Powell, MS; Kari Sausedo, MA; Amber Seelig, MPH; Beverly Sheppard, BS; Donald Slymen, PhD; Katherine Snell, BS; Steven Speigle; Martin White, MPH; James Whitmer; and Charlene Wong, MPH.

The authors are indebted to the Millennium Cohort Study participants, without whom these analyses would not be possible. The authors thank Scott L. Seggerman, BS, MS, from the Defense Manpower Data Center, Seaside, California. We also thank the professionals from the U.S. Army Medical Research and Materiel Command, especially those from the Military Operational Medicine Research Program, Fort Detrick, Maryland; and Michelle LeWark, BA, from the Naval Health Research Center, San Diego, California.

The Millennium Cohort Study team provided assistance as part of their official duties as employees of the Department of Defense and none received additional financial compensation. The VA Puget Sound provided support for Dr. Boyko's participation in this research. The Veterans Affairs Medical Center Cincinnati provided support for Dr. Miller's participation in this research.

The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Navy, Department of the Army, Department of the Air Force, Department of Defense, Department of Veterans Affairs, or the US Government. Approved for public release; distribution is unlimited. This research has been conducted in compliance with all applicable federal regulations governing the protection of human subjects in research (Protocol NHRC.2000.007).

Notes

Note. PTSD = posttraumatic stress disorder.

^a Includes baseline symptoms of posttraumatic stress disorder, depression, anxiety, or panic disorders.

Note. PTSD = posttraumatic stress disorder, CI = confidence interval, OR = odds ratio.

^a Models were adjusted for all variables shown, in addition to sex, birth cohort, marital status, race/ethnicity, military pay grade, physical component summary score, number of disease conditions, and deployment.

^b Assessed at time point prior to assessment of outcome (PTSD or depression).

^c All health care for the Marines is provided by the Navy.

^d For PTSD models, includes symptoms of depression, anxiety, or panic disorders, and for depression models, includes symptoms of PTSD, anxiety, or panic disorders.

Note. PTSD = posttraumatic stress disorder.

Note. PTSD = posttraumatic stress disorder, CI = confidence interval, OR = odds ratio, PCS = physical component summary.

^a Assessed at time point prior to assessment of lost workdays.

^b All health care for the Marines is provided by the Navy.

^c Depression was included in the mental disorder symptoms variable in PTSD analyses, and PTSD was included in the mental disorder symptoms variable in depression analyses.

^d For PTSD models, includes symptoms of depression, anxiety, or panic disorders, and for depression models, includes symptoms of PTSD, anxiety, or panic disorders.