Depressive symptoms among spouses of soldiers preparing for deployment to
Iraq are relatively high and are accompanied by increased perceived barriers
to care, according to research by military psychiatrists.
Maj. Christopher Warner, M.C., a psychiatrist, and three colleagues
surveyed the spouses (96 percent of whom were wives) of a brigade combat team
at Fort Stewart, Ga., preparing to leave for deployment. They e-mailed the
survey to a convenience sample of 872 spouses enrolled in the unit's Family
Readiness Group, and 295 (34 percent) responded to questions about the
stresses they faced and depressive symptoms. About 86 percent were married to
an enlisted soldier, the rest to
officers.
Six stressors topped the checklist on the questionnaire. At least 90
percent of the spouses said that "feeling lonely" and "the
safety of my deployed spouse" concerned them most. More than half of the
spouses said communications problems with the spouse, raising young children
alone, and balancing work and family obligations also troubled them.
About 44 percent (128) of the spouses met Patient Health Questionnaire
(PHQ-9) criteria for depression, and 24 percent (75) recorded mild depressive
symptoms, said the researchers. Higher scores on the Perceived Stress Scale
were associated with greater risk of meeting criteria for depression after
adjustment for demographic, family, and military factors.
Perceived barriers to care were higher among respondents who met criteria
for depression. Compared with nondepressed respondents, significantly more of
these spouses worried about how they would be seen by others or the effects on
their spouse's career if they entered care.
Concern about the spouse's career increased with age and with the number of
prior deployments, wrote the researchers. "[T]his provides additional
evidence that each military service must continue its programs to reduce
stigma and actual career consequences for those seeking health
care."
Preparing for deployment obviously is a stressful time for the entire
family, yet some results of the study also suggested areas of resiliency for
those affected. For instance, having more children in the home was not a risk
factor for depression, nor were repeated deployments, said the
researchers.
"Deployments are like kids—the first one is the hardest,"
said psychiatrist Harold Ginzburg, M.D., J.D., M.P.H., a former U.S. Navy
physician. Ginzburg was the guest editor of the special February
Psychiatric Annals in which Warner's article appeared.
"People gain more knowledge, learn how to handle it better, and use
the social supports around them," he said in an interview. "They
either get into the groove or get out of the service, so it's a form of
self-selection."
The effects of deployment on families won't dissipate easily, even after
their soldiers return home, so they will bear watching, said Ginzburg."
It would seem prudent to prospectively study this cohort to determine
the long-term social consequences of this conflict."
An abstract of "Psychological Effects of Deployments on
Military Families" is posted at<www.psychiatricannalsonline.com/view.asp?rid=37164>.▪