More VA Screening Needed with Increase in Women Vets
By Annette M. Boyle
DURHAM, NC – In the general population and among veterans, women suffer from depression at a substantially higher rate than men, and the mood disorder often occurs concurrently with other mental health conditions. As the number of women in uniform increases, screening for depression takes on even greater importance, both to successfully treat the illness itself and to resolve underlying mental health issues.
Currently, women account for 20% of new military recruits and 10% of veterans. As today’s recruits leave the service, the proportion of women veterans will continue to rise, with the VA estimating that that nearly 1 in 5 veterans will be female within the next 25 years.
The VA’s commitment to providing comprehensive, gender-sensitive mental healthcare for women veterans recognizes that “compared to male veterans, women veterans are more likely to have certain mental health conditions, such as depression and anxiety, as well as co-occurring mental and physical health problems” and experience higher rates of intimate partner violence and military sexual trauma, according to a feature article promoted by the VA last month. In addition, the VA acknowledges that “addressing women’s reproductive mental health concerns, such as postpartum depression or the effects of medication on a woman and her baby, requires specific knowledge and services.”
Research published recently in the Journal of Affective Disorders, meanwhile, provides greater insight into the differences in the experience of major depression and comorbid disorders between younger women veterans and their male counterparts.
John Curry, PhD, and his colleagues at the VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC) analyzed data from 1,700 veterans who had served during the operations in Iraq and Afghanistan. The data was originally collected as part of the MIRECC multi-site registry. The participants included 346 women and 1,354 men.1
The researchers found nearly half of the women (46.5%) and slightly more than one-third of men (36.3%) experienced major depressive disorder during their lifetimes (MDD-L). The proportion of women and men who had ever been diagnosed with major depression in this group was significantly higher than in other studies, perhaps because it did not draw exclusively from patients in a primary care setting. In the National Comorbidity Survey Replication, 18% of all American adults ages 18 to 64 had experienced major depressive disorder — 22.1% of women and 14.4% of men met the criteria for diagnosis.
“Some of the participants were seeking mental health services rather than primary care,” Curry noted, which “could explain why the rates of lifetime MDD were higher than they would be in a primary care clinic.” In addition, the data reflects the number of veterans who had experienced MDD at any point in their lives rather than only those with current depression.
The higher rates might also reflect deeper probing during the data gathering stage as “all participants took part in an extensive, structured, comprehensive psychiatric diagnostic interview, and so they were systematically asked about past and present symptoms in a way that would not be done in a primary care visit,” Curry told U.S. Medicine.
Because MDD and other mental health issues commonly co-occur, the researchers sought to determine whether the onset of depression and common comorbid conditions occurred at different rates or sequences in men and women. In the study, men and women with MDD-L had similar, high rates of PTSD (66.4% for men and 60.9% for women). Women were almost twice as likely to have experienced a non-PTSD anxiety disorder in their lifetimes and were about six times more likely to have had an eating disorder than men. Men were far more likely to have had alcohol use disorders.