Preventing PTSD and Depression and Reducing Health Care Costs in the Military: A Call for Building Resilience Among Service Members
The present study investigates the role of psychological resilience in protecting against the development of post-traumatic stress disorder (PTSD), depression, and comorbid PTSD and depression; and estimates the percent reductions in incidence of, and associated treatment cost savings for, each cond...
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| Veröffentlicht in: | Military medicine 2016-10, Vol.181 (10), p.1240-1247 |
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| creator | Vyas, Kartavya J Fesperman, Susan F Nebeker, Bonnie J Gerard, Steven K Boyd, Nicholas D Delaney, Eileen M Webb-Murphy, Jennifer A Johnston, Scott L |
| description | The present study investigates the role of psychological resilience in protecting against the development of post-traumatic stress disorder (PTSD), depression, and comorbid PTSD and depression; and estimates the percent reductions in incidence of, and associated treatment cost savings for, each condition as a function of increasing resilience. A retrospective cohort of mental health care-seeking service members (n = 2,171) completed patient-reported outcome measures approximately every 10 weeks as part of the Psychological Health Pathways program. Patients with low resilience were at significantly greater odds for developing physical, behavioral, and mental health conditions, particularly sleep disorder (adjusted odds ratio [AOR] = 2.60, 95% confidence interval [CI] = 1.81-3.73), perceived stress (AOR = 2.86, 95% CI = 1.05-7.75), and depression (AOR = 2.89, 95% CI = 2.34-3.57) compared to patients with moderate/high resilience. Increasing resilience across services by 20% is estimated to reduce the odds of developing PTSD, depression, and comorbid PTSD and depression by 73%, 54%, and 93%, respectively; the incidence by 32%, 19%, and 61%, respectively; and save approximately $196, $288, and $597 million in annual treatment costs, respectively, or approximately $1.1 billion total (a 35% reduction in costs). Using resilience as a preventive model may reduce health care utilization and costs in an already overtaxed health care system. |
| doi_str_mv | 10.7205/MILMED-D-15-00585 |
| format | Article |
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A retrospective cohort of mental health care-seeking service members (n = 2,171) completed patient-reported outcome measures approximately every 10 weeks as part of the Psychological Health Pathways program. Patients with low resilience were at significantly greater odds for developing physical, behavioral, and mental health conditions, particularly sleep disorder (adjusted odds ratio [AOR] = 2.60, 95% confidence interval [CI] = 1.81-3.73), perceived stress (AOR = 2.86, 95% CI = 1.05-7.75), and depression (AOR = 2.89, 95% CI = 2.34-3.57) compared to patients with moderate/high resilience. Increasing resilience across services by 20% is estimated to reduce the odds of developing PTSD, depression, and comorbid PTSD and depression by 73%, 54%, and 93%, respectively; the incidence by 32%, 19%, and 61%, respectively; and save approximately $196, $288, and $597 million in annual treatment costs, respectively, or approximately $1.1 billion total (a 35% reduction in costs). Using resilience as a preventive model may reduce health care utilization and costs in an already overtaxed health care system.</description><identifier>ISSN: 0026-4075</identifier><identifier>EISSN: 1930-613X</identifier><identifier>DOI: 10.7205/MILMED-D-15-00585</identifier><identifier>PMID: 27753559</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Adult ; Cohort Studies ; Depression - prevention & control ; Depression - psychology ; Female ; Health Care Costs - standards ; Humans ; Male ; Mental depression ; Mental Health Services - standards ; Military Personnel - psychology ; Psychotherapy - methods ; Psychotherapy - standards ; Resilience, Psychological ; Retrospective Studies ; Stress Disorders, Post-Traumatic - prevention & control ; Stress Disorders, Post-Traumatic - psychology ; Stress, Psychological - therapy ; Surveys and Questionnaires</subject><ispartof>Military medicine, 2016-10, Vol.181 (10), p.1240-1247</ispartof><rights>Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.</rights><rights>Copyright Association of Military Surgeons of the United States Oct 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c405t-7edcbe6515801840c0e6a5cd5ff6bc4996f7bd49470891a9027bc82e2168a0483</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27753559$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vyas, Kartavya J</creatorcontrib><creatorcontrib>Fesperman, Susan F</creatorcontrib><creatorcontrib>Nebeker, Bonnie J</creatorcontrib><creatorcontrib>Gerard, Steven K</creatorcontrib><creatorcontrib>Boyd, Nicholas D</creatorcontrib><creatorcontrib>Delaney, Eileen M</creatorcontrib><creatorcontrib>Webb-Murphy, Jennifer A</creatorcontrib><creatorcontrib>Johnston, Scott L</creatorcontrib><title>Preventing PTSD and Depression and Reducing Health Care Costs in the Military: A Call for Building Resilience Among Service Members</title><title>Military medicine</title><addtitle>Mil Med</addtitle><description>The present study investigates the role of psychological resilience in protecting against the development of post-traumatic stress disorder (PTSD), depression, and comorbid PTSD and depression; and estimates the percent reductions in incidence of, and associated treatment cost savings for, each condition as a function of increasing resilience. A retrospective cohort of mental health care-seeking service members (n = 2,171) completed patient-reported outcome measures approximately every 10 weeks as part of the Psychological Health Pathways program. Patients with low resilience were at significantly greater odds for developing physical, behavioral, and mental health conditions, particularly sleep disorder (adjusted odds ratio [AOR] = 2.60, 95% confidence interval [CI] = 1.81-3.73), perceived stress (AOR = 2.86, 95% CI = 1.05-7.75), and depression (AOR = 2.89, 95% CI = 2.34-3.57) compared to patients with moderate/high resilience. Increasing resilience across services by 20% is estimated to reduce the odds of developing PTSD, depression, and comorbid PTSD and depression by 73%, 54%, and 93%, respectively; the incidence by 32%, 19%, and 61%, respectively; and save approximately $196, $288, and $597 million in annual treatment costs, respectively, or approximately $1.1 billion total (a 35% reduction in costs). Using resilience as a preventive model may reduce health care utilization and costs in an already overtaxed health care system.</description><subject>Adult</subject><subject>Cohort Studies</subject><subject>Depression - prevention & control</subject><subject>Depression - psychology</subject><subject>Female</subject><subject>Health Care Costs - standards</subject><subject>Humans</subject><subject>Male</subject><subject>Mental depression</subject><subject>Mental Health Services - standards</subject><subject>Military Personnel - psychology</subject><subject>Psychotherapy - methods</subject><subject>Psychotherapy - standards</subject><subject>Resilience, Psychological</subject><subject>Retrospective Studies</subject><subject>Stress Disorders, Post-Traumatic - prevention & control</subject><subject>Stress Disorders, Post-Traumatic - psychology</subject><subject>Stress, Psychological - therapy</subject><subject>Surveys and Questionnaires</subject><issn>0026-4075</issn><issn>1930-613X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><recordid>eNpdkU1P3DAQhq2KqmxpfwAXZIlLL2nHib_CbdnQgrSrIqBSb5bjTMAoH4udIPXcP14vS3voafTOPO9oNC8hxww-qxzEl83VenNRZVXGRAYgtHhDFqwsIJOs-HlAFgC5zDgocUjex_gIwHip2TtymCslCiHKBfl9HfAZh8kP9_T67raidmhohduAMfpxeJE32MxuB1yi7aYHurIB6WqMU6R-oNMD0o3v_GTDrzO6TNOuo-0Y6Pnsu2Znu8GY5jg4pMt-TI1bDM8-qQ32NYb4gbxtbRfx42s9Ij--XtytLrP1929Xq-U6cxzElClsXI1SMKGBaQ4OUFrhGtG2sna8LGWr6oaXXIEumS0hV7XTOeZMagtcF0fk037vNoxPM8bJ9D467Do74DhHw3QhuCiUlAk9_Q99HOcwpOsSlSsJHGSRKLanXBhjDNiabfB9-oNhYHYJmX1CpjJMmJeEkufkdfNc99j8c_yNpPgDUF6LWw</recordid><startdate>201610</startdate><enddate>201610</enddate><creator>Vyas, Kartavya J</creator><creator>Fesperman, Susan F</creator><creator>Nebeker, Bonnie J</creator><creator>Gerard, Steven K</creator><creator>Boyd, Nicholas D</creator><creator>Delaney, Eileen M</creator><creator>Webb-Murphy, Jennifer A</creator><creator>Johnston, Scott L</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4T-</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88F</scope><scope>88G</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M1Q</scope><scope>M2M</scope><scope>M2P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>201610</creationdate><title>Preventing PTSD and Depression and Reducing Health Care Costs in the Military: A Call for Building Resilience Among Service Members</title><author>Vyas, Kartavya J ; Fesperman, Susan F ; Nebeker, Bonnie J ; Gerard, Steven K ; Boyd, Nicholas D ; Delaney, Eileen M ; Webb-Murphy, Jennifer A ; Johnston, Scott L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c405t-7edcbe6515801840c0e6a5cd5ff6bc4996f7bd49470891a9027bc82e2168a0483</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Cohort Studies</topic><topic>Depression - 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Academic</collection><jtitle>Military medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vyas, Kartavya J</au><au>Fesperman, Susan F</au><au>Nebeker, Bonnie J</au><au>Gerard, Steven K</au><au>Boyd, Nicholas D</au><au>Delaney, Eileen M</au><au>Webb-Murphy, Jennifer A</au><au>Johnston, Scott L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preventing PTSD and Depression and Reducing Health Care Costs in the Military: A Call for Building Resilience Among Service Members</atitle><jtitle>Military medicine</jtitle><addtitle>Mil Med</addtitle><date>2016-10</date><risdate>2016</risdate><volume>181</volume><issue>10</issue><spage>1240</spage><epage>1247</epage><pages>1240-1247</pages><issn>0026-4075</issn><eissn>1930-613X</eissn><abstract>The present study investigates the role of psychological resilience in protecting against the development of post-traumatic stress disorder (PTSD), depression, and comorbid PTSD and depression; and estimates the percent reductions in incidence of, and associated treatment cost savings for, each condition as a function of increasing resilience. A retrospective cohort of mental health care-seeking service members (n = 2,171) completed patient-reported outcome measures approximately every 10 weeks as part of the Psychological Health Pathways program. Patients with low resilience were at significantly greater odds for developing physical, behavioral, and mental health conditions, particularly sleep disorder (adjusted odds ratio [AOR] = 2.60, 95% confidence interval [CI] = 1.81-3.73), perceived stress (AOR = 2.86, 95% CI = 1.05-7.75), and depression (AOR = 2.89, 95% CI = 2.34-3.57) compared to patients with moderate/high resilience. Increasing resilience across services by 20% is estimated to reduce the odds of developing PTSD, depression, and comorbid PTSD and depression by 73%, 54%, and 93%, respectively; the incidence by 32%, 19%, and 61%, respectively; and save approximately $196, $288, and $597 million in annual treatment costs, respectively, or approximately $1.1 billion total (a 35% reduction in costs). Using resilience as a preventive model may reduce health care utilization and costs in an already overtaxed health care system.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>27753559</pmid><doi>10.7205/MILMED-D-15-00585</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; EZB-FREE-00999 freely available EZB journals |
| subjects | Adult Cohort Studies Depression - prevention & control Depression - psychology Female Health Care Costs - standards Humans Male Mental depression Mental Health Services - standards Military Personnel - psychology Psychotherapy - methods Psychotherapy - standards Resilience, Psychological Retrospective Studies Stress Disorders, Post-Traumatic - prevention & control Stress Disorders, Post-Traumatic - psychology Stress, Psychological - therapy Surveys and Questionnaires |
| title | Preventing PTSD and Depression and Reducing Health Care Costs in the Military: A Call for Building Resilience Among Service Members |
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