Mental health and substance abuse comorbidities of mIlitary personnel with current PTSD symptoms

Context: Deployment and trauma are associated with a number of mental health problems experienced by military personnel. Many of these co-occur, including posttraumatic stress disorder (PTSD), depression, suicidal ideation and attempt, alcohol and drug abuse, and anxiety. Although some of these comorbidities may be associated with combat-related traumas, others may be more associated with separate noncombat risk and protective factors. Such comorbidities pose increased treatment challenges; however, the prevalence and pattern of these comorbidities within the military are unknown. Objective: To (1) describe the prevalence and underlying structure of PTSD comorbid mental health conditions among active duty military personnel Design: Population-based, cross-sectional, anonymous survey Setting: 64 U.S. military installations worldwide Participants: 28,546 active duty military respondents from all branches of services stratified by gender, rank, and location Main Outcome Measures: Categorical models of comorbid PTSD conditions, including depression, generalized anxiety, serious psychological distress, suicidal ideation, and problem drinking Results: Almost 32% of personnel who met criteria for PTSD also met criteria for at least one of five other mental health problems; 75% of those with depression symptoms symptoms also met criteria for at least one of the other mental health problems. Latent class analysis models identified five classes of PTSD comorbidity among deployed personnel and four classes among nondeployed personnel. Separate profiles of risk and protective factors differentiated comorbid classes. Conclusion: Findings advance our understanding of the prevalence of co-occurring disorders with PTSD and how individual and military factors may influence both the risk of PTSD and co-occurring mental and substance use disorders.