Course of Depression, PTSD Varies in Soldiers: In Some Cases, Mental Health Problems Become Apparent Months after Initial Hospitalization

Article excerpt

ATLANTA -- There is no one-size-fits-all formula for the course of posttraumatic stress disorder and depression among battle-injured soldiers. Capt. Thomas A. Grieger, MC, USN, reported in a poster presentation at the annual meeting of the American Psychiatric Association.

Delayed symptom presentation and interpatient variations in the progression of both PTSD and depression suggest that current methods for screening injured soldiers' mental health, which focus on symptom assessment upon hospitalization, may cast too small a net, according to Dr. Grieger.

Of 613 consecutive soldiers who were evacuated from Afghanistan and Iraq to a U.S. military tertiary care hospital for treatment of combat injuries, 4.2% screened positive for probable posttraumatic stress disorder (PTSD) on admission and 4.4% screened positive for probable depression.

All of the soldiers included in the study had serious injuries that required hospitalization that lasted from weeks to months.

After 3 months, however, 12.2% and 8.9% of the soldiers screened positive for probable PTSD and depression, respectively. After 6 months, 12% and 9.3% of the soldiers screened positive for the respective conditions.

Based on a longitudinal analysis, 78.8% of the patients who had screened positive for either condition at 6 months had screened negative for both PTSD and depression when their initial assessment was conducted, according to Dr. Grieger.

No baseline demographic characteristics were associated with risk for posttraumatic stress disorder or depression at either the 3- or 6-month follow-ups, Dr. Grieger said at the meeting.

The study results demonstrate that "screening battle-injured soldiers for PTSD and depression during initial hospitalization does not accurately identify those who will have symptoms of the disorders at later follow-up," according to Dr. Grieger, a psychiatrist who is with the Uniformed Services University of the Health Sciences in Bethesda, Md. …