Extended U.S. Army deployments increase depression, anxiety and sleep disorders for soldiers' wives

The deployment of soldiers to the ongoing conflicts in Iraq and Afghanistan is increasing the need for mental health services provided for their family members, according to a new study by researchers at RTI International, the University of North Carolina at Chapel Hill and the Uniformed Services University of the Health Sciences. The study found extended U.S. Army deployments increase the occurrence of depression, anxiety, sleep disorders and other mental health diagnoses for soldiers' wives left at home.

The study, published in the Jan. 14 issue of The New England Journal of Medicine, estimated the relationship between the time U.S. Army soldiers spent deployed and the use of mental health services and mental health diagnoses among their wives.

"This study confirms what many people have long suspected," said Alyssa Mansfield, Ph.D., the study's lead author, now a research epidemiologist at RTI International. "It provides compelling evidence that Army families are feeling the impact of lengthy and repeated deployments to Iraq and Afghanistan. The result is more depression, more stress, and more sleepless nights."

The largest study of its kind to date, the research team attempted to assess whether there was an increase in demand for mental health services among the 250,000 wives of Army soldiers deployed to Iraq and Afghanistan.

"We were able to scientifically validate what was previously only an assertion," said Col (Dr.) Charles Engel, director, DoD Deployment Health Clinical Center at Walter Reed and associate professor of Psychiatry at the Uniformed Services University of the Health Sciences, a coauthor on the study who also assisted with access to the military data analyzed in the study. "Families experience challenges to mental health during all periods of the deployment cycle…challenges that go beyond the impact on the service member. Fortunately, it appears that the spouses - wives in particular since there were not enough male spouses to provide a strong study group - are seeking mental health services rather than struggling with these issues alone."

The study showed that women married to deployed soldiers more frequently used mental health services and were more likely to be diagnosed with conditions including depression, anxiety, sleep disorders, acute stress reaction, and adjustment disorder as compared to the wives of non-deployed soldiers during the same time period. Researchers also found that the longer soldiers were deployed the more likely their wives were to be diagnosed with a mental health condition and the more frequently they sought outpatient care for those diagnoses.

To conduct the study, researchers accessed de-identified data extracted from medical records for outpatient care received between 2003 and 2006 for more than 250,000 female spouses of active duty U.S. Army soldiers of all ranks.

Researchers estimated that among the wives of 84,000 soldiers who deployed for less than a year, there were 3,500 mental health cases above the number reported for a similar number of wives of non-deployed soldiers during the same time period. Among the 88,000 soldiers deployed for a year or longer, the number of additional mental health cases was 5,300.

Researchers cited a number of issues as potentially responsible for the increase. In addition to the fear for loved ones' safety, spouses of deployed personnel often face challenges maintaining a household, coping as a single parent, and marital strain due to deployment and induced separation of an uncertain duration.

"We hope these findings will assist policy makers to better understand and predict the demands for mental health services required by the families of deployed services members," Mansfield said. "The majority of active duty Army soldiers are married, and they and their families may need mental health services for some period beyond their active service."

Mansfield conducted the research as part of her dissertation in the Department of Epidemiology at the University of North Carolina at Chapel Hill.