Any mental disorder* | Any anxiety disorder† | AUD‡ | Suicide ideation | MDE | GAD | PTSD | PD | Alcohol abuse | Alcohol dependence | |
Model 1: unadjusted (OR (95% CI)) | ||||||||||
ResF vs RegF | 1.02 (0.89 to 1.16) | 0.83§ (0.71 to 0.98) | 1.84§ (1.45 to 2.35) | 1.27§ (1.01 to 1.60) | 0.90 (0.75 to 1.08) | 0.68§ (0.53 to 0.86) | 0.86 (0.71 to 1.05) | 0.81¶ (0.63 to 1.04) | 1.96§ (1.43 to 2.69) | 1.63§ (1.12 to 2.36) |
Model 2: adding covariates for military and sociodemographic characteristics (AOR (95% CI)) | ||||||||||
ResF vs RegF | 0.98 (0.84 to 1.14) | 0.85¶ (0.71 to 1.02) | 1.62§ (1.21 to 2.16) | 1.24 (0.95 to 1.61) | 0.91 (0.74 to 1.11) | 0.78¶ (0.60 to 1.02) | 0.84 (0.67 to 1.07) | 0.86 (0.66 to 1.12) | 1.71§ (1.16 to 2.52) | 1.48¶ (0.97 to 2.26) |
Model 3: adding covariates for LTE and child abuse (as propensity score) (AOR (95% CI)) | ||||||||||
ResF vs RegF | 0.94 (0.81 to 1.10) | 0.82§ (0.68 to 0.98) | 1.47§ (1.09 to 1.98) | 1.18 (0.91 to 1.54) | 0.87 (0.71 to 1.06) | 0.74§ (0.57 to 0.97) | 0.80¶ (0.63 to 1.01) | 0.81 (0.62 to 1.06) | 1.60§ (1.07 to 2.38) | 1.31 (0.85 to 2.02) |
Model 4: adding covariates for deployment-associated mental health training (AOR (95% CI)) | ||||||||||
ResF vs RegF | 0.94 (0.80 to 1.09) | 0.80§ (0.66 to 0.96) | 1.48§ (1.10 to 2.00) | 1.19 (0.92 to 1.55) | 0.87 (0.71 to 1.06) | 0.74§ (0.57 to 0.97) | 0.79¶ (0.62 to 1.00) | 0.78¶ (0.60 to 1.03) | 1.62§ (1.09 to 2.42) | 1.29 (0.82 to 2.02) |
Model 5: adding covariates for deployment-related characteristics and experiences (AOR (95% CI)) | ||||||||||
ResF vs RegF | 0.84¶ (0.71 to 1.01) | 0.72§ (0.58 to 0.90) | 1.36¶ (0.97 to 1.91) | 1.21 (0.90 to 1.62) | 0.82¶ (0.65 to 1.04) | 0.69§ (0.51 to 0.93) | 0.77¶ (0.58 to 1.03) | 0.70§ (0.51 to 0.96) | 1.63§ (1.04 to 2.58) | 1.06 (0.64 to 1.73) |
Deployment-related characteristics | ||||||||||
Other non-Afghanistan deployment | ||||||||||
Yes vs No | 0.76§ (0.62 to 0.92) | 0.70§ (0.55 to 0.90) | 0.69¶ (0.47 to 1.00) | 0.85 (0.61 to 1.19) | 0.76§ (0.58 to 0.99) | 0.57§ (0.42 to 0.78) | 0.69§ (0.51 to 0.93) | 0.74 (0.50 to 1.10) | 0.84 (0.51 to 1.39) | 0.56¶ (0.32 to 1.00) |
Time away in past 3 years (months) | ||||||||||
≤6 | 0.56§ (0.41 to 0.75) | 0.51§ (0.37 to 0.72) | 1.14 (0.57 to 2.29) | 0.60§ (0.36 to 0.99) | 0.64§ (0.44 to 0.93) | 0.45§ (0.28 to 0.70) | 0.71 (0.46 to 1.08) | 0.52§ (0.32 to 0.84) | 1.74 (0.69 to 4.41) | 0.61 (0.21 to 1.76) |
7–12 | 0.52§ (0.38 to 0.71) | 0.45§ (0.31 to 0.65) | 1.83¶ (0.92 to 3.64) | 0.51§ (0.29 to 0.88) | 0.50§ (0.33 to 0.75) | 0.46§ (0.28 to 0.75) | 0.57§ (0.36 to 0.92) | 0.25§ (0.15 to 0.44) | 2.98§ (1.20 to 7.40) | 0.89 (0.32 to 2.44) |
13–24 | 0.54§ (0.39 to 0.74) | 0.45§ (0.31 to 0.65) | 1.58 (0.78 to 3.21) | 0.54§ (0.32 to 0.91) | 0.64§ (0.43 to 0.96) | 0.52§ (0.32 to 0.85) | 0.61§ (0.38 to 0.97) | 0.40§ (0.24 to 0.68) | 2.22 (0.85 to 5.82) | 0.97 (0.35 to 2.66) |
25–36 | 0.51§ (0.33 to 0.79) | 0.55 (0.34 to 0.89) | 1.42 (0.58 to 3.46) | 0.54 (0.26 to 1.13) | 0.58¶ (0.33 to 1.02) | 0.56¶ (0.30 to 1.07) | 0.73 (0.39 to 1.36) | 0.46§ (0.23 to 0.93) | 1.38 (0.39 to 4.83) | 1.19 (0.34 to 4.25) |
None | Reference | Reference | Reference | Reference | Reference | Reference | Reference | Reference | Reference | Reference |
Interval from last Afghanistan deployment to survey interview date (years) | ||||||||||
<4 | 1.24 (0.92 to 1.68) | 1.37¶ (0.95 to 1.98) | 0.89 (0.48 to 1.64) | 1.78§ (1.01 to 3.14) | 1.60§ (1.07 to 2.37) | 1.45 (0.85 to 2.46) | 1.73§ (1.10 to 2.74) | 2.27§ (1.29 to 4.00) | 0.69 (0.30 to 1.58) | 1.34 (0.52 to 3.46) |
4 | 1.28 (0.94 to 1.76) | 1.29 (0.89 to 1.86) | 0.86 (0.47 to 1.57) | 1.24 (0.68 to 2.23) | 1.61§ (1.07 to 2.41) | 1.74§ (1.06 to 2.86) | 1.42 (0.88 to 2.29) | 2.10§ (1.22 to 3.62) | 0.77 (0.35 to 1.71) | 1.08 (0.43 to 2.75) |
5 | 0.95 (0.71 to 1.27) | 1.17 (0.84 to 1.63) | 0.78 (0.42 to 1.45) | 1.12 (0.65 to 1.93) | 0.96 (0.65 to 1.42) | 1.16 (0.71 to 1.88) | 1.45¶ (0.94 to 2.25) | 2.26§ (1.40 to 3.65) | 0.80 (0.38 to 1.68) | 0.87 (0.29 to 2.59) |
6 | 1.10 (0.79 to 1.53) | 1.13 (0.76 to 1.66) | 1.08 (0.56 to 2.08) | 1.09 (0.59 to 2.01) | 1.33 (0.86 to 2.04) | 1.32 (0.78 to 2.25) | 1.10 (0.68 to 1.80) | 1.47 (0.82 to 2.63) | 1.35 (0.60 to 3.04) | 0.86 (0.28 to 2.68) |
≥7 | Reference | Reference | Reference | Reference | Reference | Reference | Reference | Reference | Reference | Reference |
Total number of Afghanistan deployments | ||||||||||
≥2 vs 1 | 1.08 (0.78 to 1.49) | 1.02 (0.70 to 1.49) | 0.88 (0.47 to 1.65) | 1.43 (0.83 to 2.47) | 1.14 (0.74 to 1.76) | 0.81 (0.47 to 1.41) | 1.16 (0.71 to 1.89) | 0.67 (0.38 to 1.19) | 1.05 (0.45 to 2.45) | 0.56 (0.21 to 1.54) |
Afghanistan deployment location | ||||||||||
Kabul | 0.75 (0.51 to 1.10) | 0.72 (0.45 to 1.15) | 0.43¶ (0.17 to 1.06) | 0.57 (0.26 to 1.26) | 0.92 (0.56 to 1.53) | 0.79 (0.38 to 1.63) | 0.67 (0.37 to 1.22) | 0.52¶ (0.24 to 1.11) | 0.31§ (0.10 to 0.99) | 0.97 (0.23 to 4.17) |
Kandahar | 0.83 (0.59 to 1.17) | 0.76 (0.50 to 1.15) | 0.72 (0.28 to 1.82) | 0.64 (0.32 to 1.28) | 1.18 (0.75 to 1.86) | 0.98 (0.52 to 1.85) | 0.68 (0.39 to 1.20) | 0.46§ (0.24 to 0.91) | 0.36¶ (0.11 to 1.18) | 2.76 (0.69 to 11.00) |
Multiple | 0.92 (0.61 to 1.37) | 0.88 (0.54 to 1.43) | 0.57 (0.21 to 1.57) | 0.88 (0.43 to 1.83) | 1.39 (0.82 to 2.38) | 0.91 (0.43 to 1.90) | 0.79 (0.41 to 1.50) | 0.79 (0.36 to 1.75) | 0.38 (0.11 to 1.33) | 1.44 (0.27 to 7.73) |
Other Afghanistan related | Reference | Reference | Reference | Reference | Reference | Reference | Reference | Reference | Reference | Reference |
Cumulative duration of Afghanistan deployments (days) | ||||||||||
≤120 | Reference | Reference | Reference | Reference | Reference | Reference | Reference | Reference | Reference | Reference |
121–240 | 0.71§ (0.55 to 0.92) | 0.79 (0.58 to 1.09) | 1.19 (0.63 to 2.28) | 0.74 (0.46 to 1.19) | 0.73¶ (0.52 to 1.02) | 0.66¶ (0.43 to 1.00) | 0.85 (0.57 to 1.28) | 0.99 (0.61 to 1.61) | 1.25 (0.54 to 2.88) | 1.23 (0.48 to 3.17) |
241–360 | 0.72¶ (0.50 to 1.03) | 0.75 (0.48 to 1.17) | 1.28 (0.59 to 2.76) | 0.70 (0.39 to 1.289) | 0.66¶ (0.40 to 1.07) | 0.53¶ (0.28 to 1.01) | 0.73 (0.41 to 1.30) | 1.15 (0.57 to 2.29) | 1.44 (0.51 to 4.03) | 1.02 (0.29 to 3.57) |
≥361 | 0.49§ (0.32 to 0.75) | 0.52§ (0.31 to 0.88) | 1.01 (0.40 to 2.53) | 0.48§ (0.23 to 0.98) | 0.53§ (0.30 to 0.92) | 0.67 (0.33 to 1.37) | 0.52¶ (0.27 to 1.01) | 0.69 (0.31 to 1.56) | 0.80 (0.23 to 2.78) | 1.76 (0.47 to 6.58) |
Deployment-related experiences | ||||||||||
DEX-1 Yes vs No | 1.19 (0.94 to 1.52) | 1.44§ (1.06 to 1.97) | 1.21 (0.76 to 1.92) | 1.60§ (1.03 to 2.49) | 1.23 (0.89 to 1.70) | 1.28 (0.82 to 1.99) | 1.47¶ (0.96 to 2.26) | 2.30§ (1.32 to 4.03) | 1.41 (0.82 to 2.44) | 0.87 (0.43 to 1.78) |
DEX-2 Yes vs No | 1.47§ (1.21 to 1.78) | 1.75§ (1.38 to 2.21) | 1.23 (0.88 to 1.71) | 1.81§ (1.28 to 2.56) | 1.42§ (1.10 to 1.84) | 1.36¶ (0.98 to 1.88) | 2.07§ (1.53 to 2.81) | 1.09 (0.76 to 1.58) | 1.18 (0.80 to 1.74) | 1.20 (0.71 to 2.03) |
DEX-3 Yes vs No | 1.72§ (1.44 to 2.06) | 1.82§ (1.47 to 2.26) | 1.51§ (1.08 to 2.11) | 1.40§ (1.03 to 1.90) | 1.33§ (1.05 to 1.68) | 1.73§ (1.28 to 2.34) | 2.09§ (1.59 to 2.75) | 1.52§ (1.10 to 2.09) | 1.40 (0.91 to 2.16) | 1.69§ (1.02 to 2.78) |
DEX-4 Yes vs No | 1.35§ (1.11 to 1.64) | 1.29§ (1.01 to 1.65) | 0.96 (0.67 to 1.39) | 0.85 (0.62 to 1.18) | 1.39§ (1.08 to 1.79) | 1.02 (0.74 to 1.42) | 1.35§ (1.00 to 1.81) | 1.53§ (1.02 to 2.30) | 1.05 (0.64 to 1.72) | 0.87 (0.50 to 1.52) |
DEX-5 Yes vs No | 1.10 (0.87 to 1.39) | 1.12 (0.83 to 1.50) | 1.53¶ (0.95 to 2.46 | 0.86 (0.57 to 1.32) | 0.79 (0.59 to 1.08) | 0.98 (0.65 to 1.49) | 0.75 (0.51 to 1.10) | 0.97 (0.61 to 1.56) | 1.73¶ (0.98 to 3.05) | 1.25 (0.60 to 2.61) |
DEX-6 Yes vs No | 2.07§ (1.59 to 2.70) | 2.23§ (1.66 to 2.99) | 1.75§ (1.07 to 2.85) | 2.45§ (1.61 to 3.73) | 2.22§ (1.62 to 3.04) | 2.00§ (1.37 to 2.93) | 3.24§ (2.32 to 4.52) | 1.84§ (1.22 to 2.80) | 1.53 (0.79 to 2.94) | 1.93¶ (0.94 to 3.95) |
DEX-7 Yes vs No | 1.29§ (1.06 to 1.57 | 1.36§ (1.08 to 1.72) | 0.87 (0.59 to 1.30) | 0.82 (0.58 to 1.15) | 1.35§ (1.05 to 1.74) | 1.38¶ (1.00 to 1.90) | 1.39§ (1.04 to 1.84) | 1.37¶ (0.97 to 1.93) | 0.68 (0.42 to 1.09) | 1.24 (0.64 to 2.40) |
DEX-8 Yes vs No | 1.37§ (1.13 to 1.65) | 1.39§ (1.12 to 1.74) | 1.24 (0.85 to 1.80) | 1.01 (0.73 to 1.41) | 1.65§ (1.29 to 2.09) | 1.55§ (1.15 to 2.09) | 1.63§ (1.23 to 2.16) | 1.46§ (1.06 to 2.01) | 1.07 (0.70 to 1.64) | 1.49 (0.77 to 2.91) |
Deployment-related LTE | ||||||||||
Combat experience Yes vs No | 0.99 (0.79 to 1.24) | 1.27 (0.94 to 1.73) | 1.41 (0.92 to 2.17) | 1.08 (0.74 to 1.59) | 0.72§ (0.53 to 0.96) | 1.26 (0.82 to 1.93) | 1.72§ (1.11 to 2.67) | 1.88§ (1.13 to 3.13) | 1.38 (0.84 to 2.27) | 1.35 (0.63 to 2.89) |
Relief worker in a war zone Yes vs No | 1.23§ (1.02 to 1.49) | 1.31§ (1.03 to 1.67) | 1.29 (0.90 to 1.85) | 1.23 (0.88 to 1.71) | 1.14 (0.89 to 1.46) | 1.34¶ (0.96 to 1.89) | 1.58§ (1.16 to 2.14) | 0.98 (0.68 to 1.41) | 0.89 (0.57 to 1.39) | 2.14§ (1.22 to 3.75) |
Saw atrocities Yes vs No | 1.08 (0.89 to 1.32) | 1.23¶ (0.98 to 1.55) | 1.03 (0.70 to 1.52) | 0.92 (0.65 to 1.32) | 1.04 (0.81 to 1.34) | 1.20 (0.88 to 1.65) | 1.20 (0.90 to 1.60) | 1.49§ (1.06 to 2.09) | 1.39 (0.85 to 2.27) | 0.68 (0.36 to 1.30) |
*Any of the following: MDE, GAD, PD, PTSD, alcohol abuse or alcohol dependence.
†Any of the following: generalised anxiety disorder, panic disorder or post-traumatic stress disorder.
‡AUD includes either alcohol abuse or alcohol dependence.
§Significant at P≤0.05.
¶Significant at 0.05<P≤0.10.
AOR, adjusted OR; AUD, alcohol use disorder; DEX, deployment-related experience; DEX-1, ‘ever known someone who was seriously injured or killed’; DEX-2, ‘ever found yourself in a threatening situation where you were unable to respond because of the rules of engagement’; DEX-3, ‘ever been injured’; DEX-4, ‘ever seen ill or injured women or children who you were unable to help’; DEX-5, ‘ever received incoming artillery, rocket or mortar fire’; DEX-6, ‘ever felt responsible for the death of a Canadian or ally personnel’; DEX-7, ‘ever had a close call, for example shot or hit but protective gear saved you’; DEX-8, ‘ever had difficulty distinguishing between combatants and non-combatants’; GAD, generalised anxiety disorder; LTE, lifetime potentially traumatic experience; MDE, major depressive episode; PD, panic disorder; PTSD, post-traumatic stress disorder; RegF, Regular Force personnel; ResF, Reserve Force personnel.