Use of the Air Force Post-Deployment Health Reassessment for the identification of depression and posttraumatic stress disorder: public health implications for suicide prevention

Am J Public Health. 2012 Mar;102 Suppl 1(Suppl 1):S60-5. doi: 10.2105/AJPH.2011.300580. Epub 2012 Jan 25.

Abstract

Objectives: Military members are required to complete the Post-Deployment Health Assessment on return from deployment and the Post-Deployment Health Reassessment (PHDRA) 90 to 180 days later, and we assessed the PDHRA's sensitivity and specificity in identifying posttraumatic stress disorder (PTSD) and depression after a military deployment among US Air Force personnel.

Methods: We computed the PDHRA's sensitivity and specificity for depression and PTSD and developed a structural model to suggest possible improvements to it.

Results: For depression, sensitivity and specificity were 0.704 and 0.651, respectively; for PTSD, they were 0.774 and 0.650, respectively. Several variables produced significant direct effects on depression and trauma, suggesting that modifications could increase its sensitivity and specificity.

Conclusions: The PDHRA was moderately effective in identifying airmen with depression and PTSD. It identified behavioral health concerns in many airmen who did not develop a diagnostic mental health condition. Its low level of specificity may result in reduced barriers to care and increased support services, key components of a public health approach to suicide prevention, for airmen experiencing subacute levels of distress after deployment, which may, in part, account for lower suicide rates among airmen after deployment.

MeSH terms

  • Adolescent
  • Adult
  • Chi-Square Distribution
  • Depression / diagnosis*
  • Depression / psychology*
  • Female
  • Health Surveys*
  • Humans
  • Male
  • Middle Aged
  • Military Personnel / psychology*
  • Psychometrics
  • Public Health
  • Risk Factors
  • Sensitivity and Specificity
  • Stress Disorders, Post-Traumatic / diagnosis*
  • Stress Disorders, Post-Traumatic / psychology*
  • Suicide Prevention*