November 6, 2008

Major Depressive Episode and Treatment for Depression among Veterans Aged 21 to 39

Recent research indicates that an estimated 25 to 30 percent of the veterans of the wars in Iraq and Afghanistan have reported symptoms of a mental disorder or cognitive condition.^1,2 Untreated mental health problems can result in long-term negative consequences for the affected individuals, their families, their communities, and our Nation as a whole.

The National Survey on Drug Use and Health (NSDUH) includes questions about military veteran status, major depressive episode (MDE),³ and treatment for depression. This issue of The NSDUH Report examines data from veterans aged 21 to 39, an age group that includes veterans with relatively recent service. The report provides data on the prevalence of past year MDE, levels of impairment resulting from MDE as measured by the Sheehan Disability Scale (SDS),⁴ average number of days of the inability to carry out normal activities due to MDE, and past year treatment for MDE. It should be noted that the NSDUH does not collect data to determine whether or not veterans served in combat or in which conflicts they served. All findings presented in this report are based on combined 2004 to 2007 NSDUH data.

An annual average of 9.3 percent of veterans in this age group (an estimated 312,000 persons) experienced at least one MDE in the past year. The rate of past year MDE was higher among veterans aged 21 to 25 and those aged 26 to 29 (12.1 and 13.4 percent, respectively) than among veterans aged 30 to 34 and those aged 35 to 39 (7.5 and 8.3 percent, respectively) (Figure 1).

Figure 1. Percentages of Past Year Major Depressive Episode (MDE) among Veterans Aged 21 to 39, by Age Group: 2004 to 2007

Female veterans were twice as likely as their male counterparts to have experienced past year MDE (16.6 vs. 8.0 percent). Rates for past year MDE were similar among black, white, and Hispanic veterans aged 21 to 39 (9.6, 9.2, and 8.5 percent, respectively).

Almost all (99.2 percent) veterans aged 21 to 39 with past year MDE reported having experienced some level of resulting impairment in one or more of the role domains of home management, work, close relationships with others, and social life (Figure 2). Over half (51.7 percent) reported severe impairment in at least one of these role domains, and nearly one quarter (23.5 percent) reported very severe impairment in at least one of the domains.

Figure 2. Overall Severity of Role Impairment* among Veterans Aged 21 to 39 Who Experienced Past Year Major Depressive Episode (MDE)**: 2004 to 2007

Severe or very severe impairment in role functioning was reported by 55.4 percent of these veterans for home management, 41.3 percent for ability to work, 50.4 percent for close relationships with others, and 57.7 percent for social life.

Overall, those veterans with past year MDE who reported any impairment in any domain of role functioning were unable to carry out normal activities on an average of 57.4 days in the past year; those who reported a very severe impairment were unable to carry out normal activities on an average of 120.0 days in the past year.

More than half (59.6 percent) of veterans aged 21 to 39 who experienced past year MDE received treatment for depression in the past year. Among those who received treatment for depression, 74.0 percent saw or talked to a medical doctor or other health professional about depression and used prescription medication for depression, 20.9 percent saw or talked to a medical doctor or other health professional about depression but did not use a prescription medication for depression, and 5.1 percent used prescription medication for depression but did not see or talk with a medical doctor or other professional about depression in the past year (Figure 3).⁵

Figure 3. Percentages of Type of Treatment Received for Depression in the Past Year among Veterans Aged 21 to 39 Who Experienced Past Year MDE and Who Received Treatment for Depression in the Past Year: 2004 to 2007

With the recent combat deployments in Iraq and Afghanistan, treating the mental health care needs of veterans will be a continuing challenge for the mental health care system for years to come. Identifying and understanding the mental health service needs of service men and women, including the need for appropriate medical and therapeutic services, are a critical part of facilitating veterans' successful re-entry into civilian life and to reducing the long-term negative consequences of depression and other mental and emotional problems for veterans, their families, and their communities.