Table 1.
Summary of key survey data sources and findings
| Data source (abbreviation) | Population and context | Year(s) of data collection | Method | Sampling approach and sample size (response rate) | Key findings | Comments |
|---|---|---|---|---|---|---|
| Goss Gilroy Health Study of the Canadian Forces Personnel Involved in the 1991 Conflict in the Persian Gulf1 | Currently-serving personnel and veterans who deployed as part of the 1990–1991 Persian Gulf War, along with matched non-deployed controls | 1997 | Voluntary, anonymous paper survey | Census of all Gulf War personnel and veterans, N=3,100 (73%); stratified random sample of matched non-deployed controls, N=3,400 (60%) | Point prevalence of PTSD in Gulf War Veterans (GWVs) (PCL-M2≥50)=2.1–2.5%; major depression (PRIME MD3)=14.9–18.9%; alcohol abuse (CAGE/PRIME MD4)=13.7–14.5% | Significantly higher rate of depression in GWV’s; no increased risk of alcohol abuse |
| Canadian Forces Supplement to the Canadian Community Health Survey Cycle 1.2—Mental Health and Well-being (CCHS 1.2)5 | In-garrison, regular and reserve forces (RegF, ResF) | 2002 | Voluntary, confidential computer-assisted personal interview; performed by Statistics Canada on behalf of the CF | Stratified random sample, N=8,400 (81%) | 12-month prevalence in RegF members using WMH-CIDI6 for PTSD=2.8%; major depression=7.6%; alcohol dependence=4.0%; suicidal ideation=4.2% | Combat or exposure to atrocities was associated with increased risk of a number of mental disorders, but these accounted for little of the overall burden of mental illness |
| 2004 Health and Lifestyle Information Survey (HLIS)7 | In-garrison, RegF only | 2004 | Voluntary, anonymous paper survey | Stratified random sample, N=3,000 (62%) | 12-month prevalence of depression (CIDI-SF)8=7.1% members; 12-month suicidal ideation=3.2%; current high-risk drinking (AUDIT9≥8)=13% | PTSD was not assessed in 2004 |
| 2008/2009 Health and Lifestyle Information Survey10 | In-garrison, RegFs only | 2008–2009 | Voluntary, anonymous paper survey | Stratified random sample, N=2,300 (53%) | Point prevalence of PTSD (PC-PTSD11≥3)=8.1%; 3% reported having been diagnosed with PTSD as a chronic condition; 12-month prevalence of depression (CIDI-SF)=7.4%; 12-month suicidal ideation=3.2%; current high-risk drinking (AUDIT9≥8)=20% | No change in depression or suicidal ideation since 2004; increase in high-risk drinking since 2004; PTSD not associated with recent deployment |
| Survey on Transition to Civilian Life12 | Veterans released from military service from 1998–2007 | 2010 | Computer-aided telephone interview | Stratified random sample, N=3,500 (71%) | Self-report of having been diagnosed with a mental health problems (MHPs) as a chronic condition: PTSD=11%; other anxiety disorders=10%; depression or anxiety=20%; 12-month suicidal ideation=6% | |
| Operational Mental Health Assessment (OMHA)13 | Just past the mid-point of a 7-month deployment in Kandahar, Afghanistan; approximately 60% of respondents spent most of their time in forward areas | 2010 | Voluntary, anonymous paper or electronic survey based on the US Army's Soldier Well-being Survey14 | Near census of a single troop rotation, N=1,600 (57%) | Current symptoms of PTSD (PCL-C15≥50)=4.6%; depression (PHQ16)=4.5% | Combat exposure and home-front stressors were independently associated with MHPs |
| Enhanced Post-deployment Screening (EPDS)17 | 3 to 6 months after return from 6-month deployments in support of the CF's mission in Kandahar, Afghanistan | 2005–2010 | Confidential screening questionnaire with validated instruments followed by a mandatory 40-min interview with a mental health professional | Near census, N=17,600 (77%) | Prevalence of current symptoms of PTSD (PCL-C15≥50)=3.4%; depression (PHQ16)=3.5%; high-risk drinking (AUDIT9≥8) in 17% | Combat exposure was strongly associated with MHPs; multiple deployments had very small incremental risk of PTSD and/or depression; prevalence of PTSD and/or depression appears to be declining over time |
| Canadian Forces Base Gagetown Cohort Study18 | Retrospective cohort study of deployment-related mental disorders for personnel deployed to Kandahar Province | 2007–2011 | Clinical diagnoses abstracted from electronic health record | Census of personnel who deployed from a single CF base on a single rotation to Kandahar in 2007 | Over 4 years of follow-up, 20% were diagnosed with PTSD19 by the CF | 8% had been medically released, 15% had permanent duty limitations, and 62% had temporary duty limitations |
| Operational Stress Injury Cumulative Incidence Study20 | Retrospective cohort study of personnel deployed in support of the mission in Afghanistan | 2001–2011 | Clinical diagnoses abstracted from medical records | Stratified random sample (N=2,000) of personnel deployed anywhere in Southwest Asia from 2001–2008 | Over a median period of 4 years of follow-up, cumulative incidence of PTSD19=8% and of other Afghanistan-related mental disorders=5.2% | High threat deployment location was a powerful risk factor for deployment-related mental disorders |
| Self-reported TBI Surveillance Study21 | 3 to 6 months after return from 6-month deployments in support of the CF's mission in Kandahar, Afghanistan | 2009–2011 | Confidential screening questionnaire with validated instruments followed by a mandatory 40-min interview with a mental health professional. | Near census, N=10,000 (76%)22 | 5% screened positive for TBI on the DVBIC 23 screening questionnaire | Persistent symptoms were seen in a minority but were strongly related to MHPs |
Goss Gilroy, Inc. (1998).
PTSD Checklist, Military Version (Weathers, Litz, Herman, Huska, & Keane, 1993).
Primary Care Evaluation of Mental Disorders questionnaire (Spitzer et al., 1994) as modified for the Iowa Persian Gulf Veteran Study (The Iowa Persian Gulf Study Group, 1997).
Symptoms of alcohol dependence were assessed using a combination of the CAGE questionnaire (Mayfield, McLeod, & Hall, 1974) and the PRIME MD questionnaire (Spitzer, Kroenke, & Williams, 1999), using the algorithm of the Iowa Persian Gulf Study Group (1997).
Documentation of study methods can be found at Statistics Canada (2004). An almost identical study (Statistics Canada, 2002) was done on the Canadian general population at the same time, permitting comparisons between the civilian and military populations.
World Mental Health—Composite International Diagnostic Interview (Kessler et al., 2004).
DND (2005).
Composite International Diagnostic Interview—Short Form (Kessler, Andrews, Mroczek, Ustun, & Wittchen, 1998).
Alcohol Use Disorders Identification Test (Bohn, Babor, & Kranzler, 1995).
DND (2010).
Prins et al. (2003).
Thompson et al. (2011).
Garber et al. (2012).
Office of the Surgeon General (2006).
Weathers, Litz, Huska, and Keane (1994).
Spitzer et al. (1999).
Zamorski (2011a).
Sedge, Devlin, and Joshi (2012).
DSM-IV diagnostic criteria (American Psychiatric Association [APA], 2000) are used for mental disorders in the CF.
Boulos and Zamorski (2013).
Zamorski (2009).
Self-reported TBI data pertain to a sub-sample of 9,900 of those who completed a version of the screening questionnaire that had TBI screening items.
Defense and Veterans Brain Injury Center screening questionnaire (Warden & Ryan, 2005).