Gender stratified factors associated with Major Depression among Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans seeking VA Health Care

The female Veteran population has increased significantly in size and diversity. Previous studies have seen higher rates of major depression among returning female OEF/OIF Veterans. To explore the mental health needs of this growing and unique population, we identified socio-demographic and clinical characteristics associated with major depression diagnoses in returning Veterans and determined if and how they differed by gender. We obtained data from the VA OEF/OIF roster and VA clinical/administrative databases including all personnel discharged from the U.S. military from October 1, 2001 to September 2010. Multivariable logistic regression models were used to determine associations with major depression. Results confirmed that female Veterans were more likely to have a major depression diagnosis (8.7% vs 5.1%, p<.0001; OR=1.76). In female Veterans, factors associated with major depression after adjustment were Hispanic ethnicity (OR = 1.26), other psychiatric Illnesses (OR=5.41 ), alcohol abuse disorder (OR=2.48), substance abuse disorder (OR=1.90 ), service connected disability (100% OR = 5.41), back/joint disorder (OR=1.57 ), and hypertension (OR = 1.35 ). Among male Veterans, in addition to the above factors, not identifying as White, Black, or Hispanic (aka “Other” ) (OR=1.14 ) and older age (10 year OR=1.06 ) were associated with major depression. Race/ethnicity and age were associated differently with major depression within each gender group and service connected disability had a much higher association with major depression in women. Further research on gender differences in the relationship between major depression and disability, age, and race/ethnicity is needed in this cohort.