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Objectives. To evaluate gender, age, and race/ethnicity as predictors of incident mental health diagnoses among Operations Iraqi Freedom, Enduring Freedom, and New Dawn veterans.
Methods. We used US Veterans Health Administration (VHA) electronic health records from 2001 to 2014 to examine incidence rates and sociodemographic risk factors for mental health diagnoses among 888 142 veterans.
Results. Posttraumatic stress disorder (PTSD) was the most frequently diagnosed mental health condition across gender and age groups. Incidence rates for all mental health diagnoses were highest at ages 18 to 29 years and declined thereafter, with the exceptions of major depressive disorder (MDD) in both genders, and PTSD among women. Risk of incident bipolar disorder and MDD diagnoses were greater among women; risk of incident schizophrenia, and alcohol- and drug-use disorders diagnoses were greater in men. Compared with Whites, risk incident PTSD, MDD, and alcohol-use disorder diagnoses were lower at ages 18 to 29 years and higher at ages 45 to 64 years for both Hispanics and African Americans.
Conclusions. Differentiating high-risk demographic and gender groups can lead to improved diagnosis and treatment of mental health diagnoses among veterans and other high-risk groups. (Am J Public Health. 2017;107:329-335. doi:10.2105/AJPH.2016.303574)
Veterans who served in Operation Enduring Freedom, Operation Iraqi Freedom, or Operation New Dawn (OEF/ OIF/OND) are unique from veterans of other eras in sociodemographic composition and in Veterans Health Administration (VHA) service use. Approximately 61% of all separated (not on active-duty military service) OEF/OIF/OND veterans have used VHA services since October 1, 2001, making the VHA the single largest health care provider for these veterans.1 Women account for 12.2% of OEF/OIF/OND-era VHA users, and represent the fastest growing segment of new users.1 3 Nearly one third of men and 45% of women in this cohort are non-White, compared with the 18.4% of men and 29.3% of women veterans from all other eras.4 According to recent estimates, 57.6% of OEF/OIF/OND veterans who have used VHA services have been diagnosed with a mental health condition.1
Research has demonstrated an increase in the prevalence of mental health diagnoses in this cohort as the recent conflict has continued,5 7 and identified sociodemographic differences, with women more often diagnosed with depression, and men more often diagnosed with posttraumatic stress disorder (PTSD) and alcohol...