| Abstract
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Operations in Iraq and Afghanistan have involved the frequent and extended deployment of U.S. military personnel, many of whom are married, have children, or both. The effect of deployment on mental health problems in military spouses and children is largely unstudied. Research is needed to inform assessment and allocation of military mental health resources. This study characterized outpatient mental health diagnoses among the family members of U.S. military personnel associated with deployment in support of Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF). The risk and rate of mental health diagnoses associated with prolonged (≥ 7 months) OIF and OEF deployment between January 1, 2003 and December 31, 2006 were compared using electronic medical record data for spouses (n=267,126) and dependent children (n=348,012) of active duty U.S. Army personnel. After adjusting for sociodemographic characteristics and the family member's mental health history, the excess of mental health cases attributable to longer spousal deployment was 34.7 per thousand (95% CI: 29.7-39.6). It was greater for disorders of depression (22.7 cases; 95% CI: 18.4-29.9), sleep (15.8 cases; 95% CI: 12.9-18.6), stress (15.2 cases; 95% CI: 11.7-18.8), and anxiety (13.2 cases; 95% CI: 9.8-16.6), with diagnosis rates 11 to 24 percent higher for these same conditions. Excess mental health cases among children attributable to prolonged parental deployment were 14.1 per thousand (95% CI: 10.6-17.6), and were greater for depression (3.6 cases; 95% CI: 1.6-5.6), stress (9.0 cases; 95% CI: 6.5-11.5), and pediatric behavioral disorders (4.7 cases; 95% CI: 2.9-6.4), with diagnosis rates 12 to 39 percent higher for these same conditions, as well as bipolar disorder. Excess cases and rates varied for male and female children, and by military installation for all family members. This is the first large-scale study examining the effects of deployment on mental health problems in military families. Findings indicate prolonged periods of deployment are associated with increased occurrence and rates of mental health diagnoses, and have relevance for informing prevention efforts and service provision at locations with substantial troop deployment.
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