Psychiatric comorbidity pattern in treatment-seeking veterans

Psychiatry Res. 2017 Dec:258:488-493. doi: 10.1016/j.psychres.2017.08.091. Epub 2017 Sep 1.

Abstract

This study investigated comorbidity patterns in treatment-seeking veterans and currently-serving Canadian Forces members of an outpatient mental health clinic from September 2006-September 2014. Using a retrospective cohort design, latent class analysis was conducted to determine latent classes of comorbidity (including posttraumatic stress disorder [PTSD], major depressive disorder [MDD], generalized anxiety disorder, panic disorder, and alcohol use disorder [AUD]). Multiple logistic regression was used to determine which covariates (age, gender, number of deployments, and service duration) were predictors of latent class membership. Among the 486 participants, 79.2% had more than one probable mental health condition. The most common comorbidity was PTSD and MDD (61.5%), followed by PTSD and GAD (52.3%). Among those with PTSD, almost all (95%) had a subsequent condition, predominantly MDD (82.6% of those with PTSD had MDD). A two-class model was the best fitting model with a high comorbidity and a low comorbidity class. Older age and shorter service duration significantly increased the probability of being in the high comorbidity class when not controlling for member status. Results showed that treatment-seeking veterans and military personnel have high rates of comorbidity, particularly alongside PTSD. Therefore, it is critical for clinicians to be able to assess and treat comorbidity.

Keywords: Canadian Forces; Major depression; Posttraumatic stress disorder.

MeSH terms

  • Adult
  • Alcoholism / epidemiology
  • Alcoholism / therapy
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / therapy
  • Canada
  • Comorbidity
  • Depressive Disorder, Major / epidemiology
  • Depressive Disorder, Major / therapy
  • Female
  • Humans
  • Male
  • Mental Disorders / epidemiology*
  • Mental Disorders / therapy*
  • Mental Health Services / statistics & numerical data*
  • Middle Aged
  • Panic Disorder / epidemiology
  • Panic Disorder / therapy
  • Retrospective Studies
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / therapy
  • Veterans / psychology*
  • Veterans / statistics & numerical data*
  • Young Adult