Deployment-Related Psychiatric and Behavioral Conditions and Their Association with Functional Disability in OEF/OIF/OND Veterans

Understanding the factors that influence veterans’ functional outcome after deployment is critical to provide appropriately targeted care. Mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) have been related to disability, but other psychiatric and behavioral conditions are not as well examined. We investigated the impact of deployment‐related psychiatric and behavioral conditions on disability among 255 OEF/OIF/OND service members and veterans. Structured clinical interviews assessed TBI and the psychiatric conditions of depression, PTSD, anxiety, and substance use. Self‐report questionnaires assessed disability and the behavioral conditions of sleep disturbance and pain. Over 90% of participants had a psychiatric and/or behavioral condition, with approximately half presenting with ≥ 3 conditions. Exploratory factor analysis revealed 4 clinically relevant psychiatric and behavioral factors which accounted for 76.9% of the variance: (a) depression, PTSD, and military mTBI (deployment trauma factor); (b) pain and sleep (somatic factor); (c) anxiety disorders, other than PTSD (anxiety factor); and (d) substance abuse or dependence (substance use factor). Individuals with the conditions comprising the deployment trauma factor were more likely to be substantially disabled than individuals with depression and PTSD, but no military mTBI, OR = 3.52; 95% CI [1.09, 11.37]. Depression, PTSD, and a history of military mTBI may comprise an especially harmful combination associated with high risk for substantial disability. Resumen Entender los factores que influyen en el funcionamiento de los veteranos después de los despliegues militares es clave para proporcionar cuidados específicos apropiados. La lesión cerebral traumática leve (mTBI) y el Trastorno de Estrés Postraumático (TEPT) han sido vinculados a discapacidad, pero otras alteraciones psiquiátricas y conductuales no han sido tan evaluadas. Investigamos el impacto de Alteraciones Psiquiátricas y Conductuales relacionadas a Despliegues militares en la discapacidad de 225 veteranos y miembros de servicio OEF/OIF/OND. Entrevistas clínicas estructuradas evaluaron TBI y alteraciones psiquiátricas como Depresión, TEPT, Ansiedad y Uso de sustancias. Cuestionarios de autoreporte evaluaron discapacidad y las alteraciones conductuales trastornos del sueño y dolor. Sobre el 90% de los participantes tenían una alteración psiquiátrica y/o conductual, con aproximadamente la mitad presentando ≥3 alter