Temporal Trends in the Epidemiology of Psychiatric Disability in the US Army: 2005-2010

Background: Psychiatric conditions in US military personnel are of increasing interest to military policy makers, particularly as risk factors for suicide and post-traumatic stress disorder (PTSD). Assessment of mental health before and after deployments have increased the diagnosis of psychiatric conditions and referrals to mental health professionals. However, little research is available describing recent trends in the epidemiology of disability discharges for psychiatric conditions. Methods: Disability evaluations for psychiatric conditions among Army personnel that began between FY 2005 and FY 2010 were included in this analysis (n=15,297). Data on unfitting conditions, rating, and disposition were obtained from the US Army Physical Disability Agency. Rates were calculated per 10,000 service members, using aggregate service population data from the Defense Manpower Data Center, and were stratified by year to describe temporal trends. Results: Rates of psychiatric disability have doubled in the US Army from 2005 to 2010. The proportion of psychiatric disability cases related to PTSD has increased from 3% in 2005 to 68% in 2010. Increases in disability rating of psychiatric conditions have also been observed. In 2010 93% of psychiatric disability was rated higher than 30% and medically retired, as compared to 2005 when 16% of psychiatric disability was rated higher than 30%. Discussion: Increasing rates of psychiatric disability in the Army accompanied by increasing ratings indicate changes in psychiatric disability during the period from 2005 to 2010. Further research is necessary to determine the association of changes in combat exposures, risk factors, comorbidity, and disability policy with psychiatric disability.